Mom & Me Three Archive

As of May 1, 2010...

2010-04-29T22:24:00.002-07:00

...Blogger will no longer allow FTP publishing. Updates to this blog, which will probably be few to none, since this section of The Mom & Me Journals dot Net is, essentially, closed by time, can be found at http://momandmethreearchive.blogspot.com. This section of the journal will also remain at in it's domain directory, so accessing links should not present a problem.

So, I was talking to MCF yesterday...

2005-12-30T18:02:00.000-07:00

...and mentioned that I was both surprised and pleased that Mom has not picked up my cold.
    "I'm not surprised," she said. "You're the one who's run down." I hadn't thought of it this way, but that's true. Mom get's plenty of rest, eats well and leads a highly stress free life. I, on the other hand, go into sleep deficit or sleep restlessly on a fairly regular basis, try to eat well but often skip lunch and occasionally skimp on dinner, and while I can't say that I am most of the time stressed to my limits, I am always "on", even when I'm sleeping, just in case. I guess, after awhile, that tends to compromise one's immune system.
    This morning I was talking to MCS. I mentioned to her that, contrary to what I used to believe, that I would be "exhausted" when Mom dies, in fact I'm beginning to suspect that I will probably experience an energy and spirit revival immediately after her death, as many do who are living with Ancient and Infirm Ones. "I'm exhausted now," I told her, "and expect I'll remain that way for the rest of her life."
    This isn't to refute what I wrote earlier this fall, that our life is eminently more peaceful that it has been over the last five years. It is, and I'm definitely appreciative. I worked hard to get us here. Which is the point. I work hard to keep us in this peaceful place, as well.
    This morning I did a little internet research, trying to find information about the history of the nursing home phenomenon, from way back to now. I wasn't terribly successful but in my web wanderings I discovered a book which I immediately ordered: The History of Old Age, edited by Pat Thane; the U.S. publication of his British book, The Long History of Old Age. I was going to order the book through Amazon.uk until further searching led me to the U.S. publication, which is cheaper and will be much easier to acquire. The first review cited here is the one that intrigued me (the second cautioned me about what to expect). My mother and I have had several conversations throughout the years concerning whether it's true that old age is a fairly recent phenomenon, which The Literature and The Media would have us believe. We've each surmised that, although in centuries past, yes, childhood death rates have been high, but it would seem that if one survived childhood the chances were good that one would live to at least the closer reaches of elderhood. It seems that we surmised correctly.
    The reason we've been discussing old age lately is that in one of Mom's recent tabloids [hold on while I reference it: Globe (unfortunately for this referencing, one of American Media, Inc.'s publications that isn't online); January 2, 2006; pg. 55] appeared a short article about Kitty Carlisle, most ubiquitously known for her appearances on To Tell the Truth, also a legitimate star of stage and screen and the widow of Moss Hart. Mom spotted the article and passed it across to me one morning recently at breakfast. It is written in a Ripley's Believe It or Not style with the following information: Ms. Hart, who is 95, is astonishingly alive and active. She is currently starring in a one woman, 75 minute show, My Life on the Wicked Stage, which is traveling across country. A point is made of mentioning that she stands the entire time she is onstage. She continues her active social life, going out almost every night. She discusses her health routine, which includes "eating right and getting plenty of exercise. My instrument - my voice - is inside my body so I have to exercise. I still do 30 leg lifts and get on my treadmill several times a week. I can put my legs over my head and touch the floor." She adds, "People are always saying how good I look for my age. If I knew what my secret was, I'd be the richest woman in the world. I spend about $8 a year on makeup and put Nivea on my face every day and night. That's all I do." She mentions that 17 years ago she had a face lift. Two years ago, "I went to my doctor...and said, 'Surely you can do something to make me look better'. He turned me to the light and said, 'Go home.' I never thought of it again."
    After I read the article I was more curious to see what my mother's reaction to it was than to divulge mine. I finished it and with a smile said, "Well, what do you think about that?!?"
    "I think it's wonderful! Good for her!" There was not a hint of envy for this 95 year old Wonder Woman, nor any regret that her own elderly life was not nearly as astonishing. This didn't surprise me...my mother is an amazingly accepting creature. As I read the article, though, I watched my own reactions: A variety of internal questions formed under the heading of What Accounts for the Difference Between My Mother and Kitty Carlisle? I don't spend a lot of time worrying about these aspects of old age, but when I hear about an 86 year old surfer, or a 92 year old in New England still working full time, or a Kitty Carlisle, it's hard not to wonder why the ambitious, dynamic individual my mother has been most of her life is now 88 with Dementia-Lite, Chronic Renal Failure, Anemia Due to Chronic Disease, in need of full-time caregiving by a dedicated daughter.
    I always finally decide: This is one of the mysteries we are still trying to solve. Wouldn't we all like to live to be 95, as vibrantly as Kitty Carlisle? Why do only a very few of us become Kitty Carlisle? Some of us who try very hard to do this don't make it; I'm thinking of Jim Fixx. Often it seems it is those who aren't working hard at it who accomplish it. This is one of the most mysterious aspect of life, the one we humans have spent an inordinate amount of time trying to understand and, still, all we can come up with is, some do and some don't. It's an incredibly sobering realization, especially when you are a caregiver to An Ancient One. The best bet, I think, especially if one is caring for An Ancient One, is to forget the questions, put the mystery aside while you're with your Ancient One and she is with you. Despite everything one, as a caregiver, attempts to do to ameliorate what one is tempted to consider the "health choices" of old age, my experience has told me that life works better when you follow your Ancient One's determination rather than your own, regardless of where that leads. Consider yourself lucky if you are caring for An Ancient One who is as accepting and regret free as my mother. If your's isn't, though, while you probably cannot keep your Ancient One from their spiritual misery, your path will be easier if you do not join them in it. If you think counseling will help your Ancient One, make sure you delegate this job to someone else. Do not attempt it yourself. If nothing helps, rest yourself in the knowledge that your Ancient One is living the eccentric mystery of her or his elder life in exactly the same way as my mother and as Kitty Carlisle; the fact that he or she remains alive is an indication that they are who they are meant to be.

I'm usually loathe to take cold medication...

2005-12-27T17:34:00.000-07:00

...but when I realized my nose was going to continue running the marathon today I imagined myself dripping fresh cold virus all over the house and decided, not a good idea when living with an Ancient One. So I picked up a generic preparation that contains only ibuprofen and a nasal decongestant.
    So far, though, we've been lucky. She hasn't shown any signs of picking up my cold. I hope this continues.
    The Mom's up.
    Later.

Sometimes I'm a little slow.

2005-12-27T08:59:00.000-07:00

    Although I've alluded to the following in previous reports here, last night I finally understood it, due to a conversation we had prior to Mom retiring: Whether I am her daughter to her remains a mystery but I realized that I am a contemporary. It is possible to be both a child of and a contemporary to an Ancient One.
    The conversation was so insignificant I can't remember the detail. It centered around discussing some aspect of life, mentioned in the news, that has changed drastically since she was raised in Mechanicsville. At one point she asked me to clarify something of which I had no knowledge.
    "If you've forgotten, Mom, then your guess is as good as mine, since I wasn't there."
    She gave me a direct "what's you're problem" look. "It happened in Mechanicsville," she prompted.
    "That's why I have no memory of it, Mom. I wasn't there. You hadn't even imagined having me, probably."
    "Well, then, where were you?!?" She clearly thought I was joshing her and she wasn't appreciative.
    "I wasn't anywhere, Mom."
    "You've said that before. Why do I remember you there?" She still had that "this is your problem, not mine" tone.
    I paused for thought. "Well," I posited, "if reincarnation is true, maybe my essence was there as someone else, someone you knew who was to die shortly and be reborn several decades later as your daughter. Then again, maybe I'm wrong about not yet being a gleam in your eye. Maybe you imagined all your children long before you had them and I was there. All I know, and I'm willing to accede that what I know could be superficial and insignificant, is that I was born to you in 1951 and, after my birth, you didn't visit Mechanicsville again until, hmmm, I think it was in 1995 when you went to Cedar Rapids for that stockholder's meeting."
    She listened carefully. Made no comment.
    "Are you confused?" I prompted.
    She fixed me with a determined look. "No, I just can't figure out how it is that it seems as though I've known you all my life."
    I laughed. "Well, that's easy! Maybe I'm right! Maybe you have known the idea of me all your life and when I was born I became the idea manifest!"
    She laughed, too. "I think you may have something there..."
    Which is the best confirmation anyone can get from my mother.

    This reminds me of the conversation I had with Mom about a week ago about why she asked me to be her companion rather than making arrangements to combine her life with that of one of my married-with-children sisters. I can't remember why it occurred to me to ask her, although it's a subject over which I've mulled many times. I've also thought I knew the answers:

I was the single one which, from the point of view of my mother's generation, means that I was not suffering Caregiver Burnout from being a wife and mother and would probably be amenable to taking care of her, when care would be what was needed;
My life up to that point had been pretty adventurous with no obvious hitches that indicated I wouldn't want to be her companion;
She and I had accidentally (probably due to my single status and her desire to not interfere in the married-with-children lives of her other daughters, although she was always available to help, of which only one daughter took advantage), throughout the years, forged and nurtured a close, person-to-person relationship beyond our mother-daughter status and had included one another in our intellectual and physical adventures;
I had lived in her chosen home, the Phoenix Metroplex, on and off throughout the years and she knew I would have few and easily adjusted qualms about returning, despite my love for my found home of Seattle; thus, the detail of her life wouldn't need to change or would change, as necessary, slowly and easily instead of drastically and with personal upset.

    When I asked my question I also asked her to take some time to think back and try to remember what she was thinking that fateful day when she called me and said, "What would you think about moving back here to live with me? I think I've had just about enough of living alone."
    She took some moments. I waited patiently at her feet, her faithful dog, my eyes trained, as always, on her upturned, searching-the-ceiling-of-her-mind face.
    Finally, changing her view to straight ahead, letting me know that she was satisfied with what she found, she pronounced slowly and definitively, "Freedom of thought."
    A left field fast ball. I reeled. I knew there had to be more behind this response that the surface revealed. I've always considered every member of my born-into family as permanently sloshing about with abandon in The Fields of the Lord of Infinitely Ranging Thought. Except for one friend whom I've had since 1983, I've considered every member of my family my only strongholds for companionship during Discussions of Unfettered Thought. I attribute many rituals of my own unfettering directly to each member of my family. My unfetterings continue through them, as well. I've always felt that each member of my family and I are joined at the hip, working hard and constantly to understand what each is thinking, consider it with and against our own thoughts and absorb and love, with astonishingly respectful equanimity, the details of our inner and outer lives. I learned to do this within my family and count on my family to continually nourish these abilities. I know that my mother feels much the same about our family and The Realms of Thought. Thus, I knew that I couldn't assume anything from my mother's short, pithy response.
    Instead of pointing out that we are a family of free and mutable thinkers, thus couldn't this apply to her living with any of her daughters, I asked, "What do you mean?"
    Again, she took awhile to answer.
    "I knew," she said, "with you I wouldn't be just another member of the family who would be listened to but would be...hmmm...let me think...."
    "Can I help you?"
    "Sure, if you're wrong, though, I'll tell you."
    "Good. ...whose thoughts and feelings wouldn't be hijacked by what would seem to be the more urgent thoughts and feelings of spouses and children."
    "There, you've got it!" She seemed relieved. "Families are so busy, nowadays, you know." An interesting observation, considering that she was born into an extremely busy family and probably passed this trait on to us.
    "And I didn't make a second family."
    "Right."
    "Wow. I never would have guessed that. I thought..." and I felt it would be safe to tell her why I previously thought, of all her daughters, she asked me to be with her, so I did.
    "No, no, no," she said. "When you asked me to consider living with you in Seattle and we realized I couldn't stand Seattle, I expected that you'd decide not to come live with me."
    "Really! Well, you should know, then, once I made up my mind, trying you out in Seattle was just an attempt at an adjustment. I had no intention of not being your companion if you hated Seattle. I just thought, you know, I just thought I'd try. Also, for your information, I haven't regretted leaving Seattle. I miss the weather but it'll always be there."
    "Well, good."
    So. That's the story. I can't help but fill in a little. I'm positive my mother wasn't impugning any of my sisters' characteristics of thought. Immediate families, though, always take precedence over past and future families. When one remains single, as I did, one's immediate family is one's past and future family if they are a part of a family they continue to love and enjoy throughout their lives. Thus, one is free to continue a level of in depth involvement with one's parents and sisters that one would necessarily shave in the face of immediate husbands and children. When relationships with siblings and parents are kept up it is usually through the efforts of the single sibling, if one exists. Otherwise, relationships are stored for use in one's later years. My mother knows how this works. This is what happened between her and her sisters and parents. In her case, the glue of a single sibling didn't exist and, as it turned out, her later attempts to rebind with her siblings were tragically truncated by her brother's and sister's health problems.
    How had I kept up the relationship with my mother while I plied my singular life?

During the periods of time I lived and worked within the Phoenix Metroplex I would make it a point to have dinner with my parents, then my parent, at least a few times a week.
Holidays were always spent with my parent/s.
Occasionally, when in the process of moving to and from other places, I lived with them for short periods of time.
During one particularly cogent period in my late 20s and 30s when I lived close to my parents, my mother and I would meet a few evenings a week to read aloud and discuss books in which we had a mutual interest.
When I lived in Seattle and my mother lived alone in Mesa she would call me every Saturday at 1700 Seattle time for an extended week review. When I brought this to her attention, with much amusement, on the occasion of her not calling me one Saturday and me looking, by phone, all over the Phoenix area for her, wondering if she was all right, she denied, with barely hidden embarrassment, that she habitually called me. When I laid out my concern when she hadn't as proof that she did, she expressed relief that someone knew her habits well enough to worry about whether she was okay. As it happened, she was. She'd been out on the town with her sister.
I've always been in the habit of "saving" snippets of information for her that I knew would pique her interest and provoke discussion. She has done the same for me.
We've had shared adventures, too, some of them illegal, when she's visited me in far flung locations or we've traveled together since I came to live with her.

    Most of all, though I believe the amount of attention I pay to her in her Ancient Years, the willingness (with reservations, including the reservation of my desire for solitude during the holidays and my desire not to negotiate us into episodes that have already proved disastrous) with which I allow her preferences and my inability to consider that her life is impinging on mine are the bedrocks of what she was expressing. It is unusual in the life of a dependent Ancient One to be able to live out one's life precisely as one wishes without feeling that one's life is hampering, is a distraction or is incidental to the lives of others.
    I am struggling, here, not to make comparisons while I enumerate the advantages, to her and me, of the life we lead journeying together in her Ancient Years. I have often, in despair, considered that my mother would be better off surrounded by a family of more-than-one (me), including the young and the middle aged. I have wished that an arm of our family was closer and more able to host my mother when my need for my beloved solitude becomes so overwhelming that my behavior becomes uncontrollably wretched. As well, my continued, fundamental belief is that Ancient Ones both deserve and benefit from frequent exposure to relations of all ages. I still, though, consider myself lucky and blessed to be doing what I'm doing with my mother. I'm sure my mother feels equally lucky and blessed to have her single, family oriented daughter walking with her through her final years.
    Families beget families beget families. In our culture, at least in the WASPish arena, families are, at this time, primarily nuclear. Even though, especially within the last more-than-a-few decades, this nuclearity is stretching to accommodate "blended" families, single parent families and families extended with older and/or abandoned relatives, at this time lucky is the family who somehow manages to produce a single sibling who remains family oriented. Had circumstances been different, had my mother successfully petitioned to spend her last years in the bosom of one of the families that came out of the family she created, I know that she would have been fine and happy. MFASRF, many years ago, upon meeting my mother (she was in her mid 60s at the time) pronounced her "resigned, in the best sense of the word." She is. She takes it as it comes and if I hadn't come to be with her she would have taken it well. Although I have rarely dared to imagine that this life my mother and I lead is my mother's preference and was from the beginning, I have often hoped, against hope, that it is. I'm glad I found the presence of mind and the courage to "ask...
    ...and it shall be given unto you."
    Time to nudge The Mom into her morning.
    Later.

"I think I've had just about enough ham...

2005-12-26T23:54:00.001-07:00

...got anything else for dinner?"
    I (and those of you who know my mother, I'm sure) never thought I'd hear her utter this sentence in regard to ham, especially HoneyBaked Ham. She did, though, tonight. Yes, I had something else: One serving left of a chicken concoction I worked from the picture attached to a magazine recipe that attracted Mom's eye and palate. I mention this here because I don't think I'll be getting over to the Tests & Meds site tonight. Don't expect Stat Ketchup until tomorrow.
    Thus, a few more reminders for myself: Bowel Movement at 1430 today; Very light lunch of cottage cheese at about 1715; Ham for breakfast, yet again, her request.
    I continue with cold. I thought I'd be able to get away with feeling good through the entire infection but about 10 hours ago I began feeling physically bad, in the way colds tend to make one feel bad. Surprised me. None of today's badness is amenable to ibuprofen, as the sore throat and fever were. I'm not a fan of using OTC cold preparations on myself, either. I tried to take a nap at about 1500. I felt as though I could use one, unusual for me, but my nose, which has now graduated to "Running the Marathon" status, would allow me to sleep. So, I've been dragging all afternoon and evening. This hasn't affected my generally good mood, though, which is an unexpected surprise.
    I'm trying hard not to pass this cold on to Mom. I'm keeping our tissues separate; no kissing allowed, which is hard on both of us; I'm indulging in obsessive hand washing and lotion application to keep my hands from cracking; every time I prepare something for her I breathe "in the other direction", which is an interesting challenge. So far so good. She's told me several times that she simply refuses to contract my cold. Good. I wish I'd thought to use this tactic on whomever it was that blessed me with it.
    It's been so long, years, in fact, since I've been at all ill from an infectious disease that I'm feeling rather like a child who's experiencing her first cold. I'd forgotten that I lose my appetite; my skin becomes super-sensitive; I drink water as though it's going out of style; my head feels like it's attached to someone else's body and I'm using it through a LAN.
    Something I've been meaning to mention here of which I was reminded when I mentioned it to a friend: I alluded, some posts ago, to the possibility that I suffer from a type of Seasonal Affective Disorder. I'm only half joking. I'm finding, this winter, which is unusually warm, dry and sunny for this area this time of year, that the sun is irritating me, especially in the mornings when it floods the front of our house and I can't get away from it unless I want to spend all my time in the back of the house, which isn't possible. I remember this feeling during the summers in Seattle. Although they lasted only two months and were what most people would consider perfect summers, after a week of 18 hours of sun every day I'd find this natural perfection tedious and couldn't wait for the other 10 months of the year when Seattle was shrouded in mist. I wonder if anyone's done a study on the inverse of what is considered to be standard SAD: Those of us who prefer gray, wet days and find too much sun troublesome. I doubt that there are many of us but I remember, when I lived in Seattle, reading some commentary by Jonathan Raban, who made the Pacific Northwest his home, that there are some of us who can't get enough of "the gray" [thank you, Seal]; not many, but our preference is at least as strong as the general preference for non-precipitous days.
    Yet one more reminder tick: A few evenings ago I asked my mother if she remembered why she originally asked me to be her companion through her Elder and Ancient years and if so, would she tell me why. I thought I already knew the answer. I was wrong. Her answer startled me. I'll cover that later.
    I think I can get to sleep, now, regardless of what my nose decides to do. Here's hoping.
    Later.

"I don't know about you, but..."

2005-12-25T17:16:00.002-07:00

...that's a direct quote from my mother; her way of prefacing an opinion upon which she wants either confirmation or argument. I'm using it with the following completion: ...I'm having a wonderful Christmas this year! I think Mom is enjoying hers as well. She certainly hasn't been able to forget that it's Christmas. I turned on the Christmas cable music channel soon after she awoke: I've wished her "Merry Christmas" and "Feliz Navidad" several times; teasing sung every Christmas song I know that's played (and a few I don't know but thought I could wing) to her. I've continued baking. The bread turned out today, after which I used the rest of the pumpkin in a concoction I call "Pumpkin/Apple/Walnut Bread", a quick leavened bread. Sounds delicious, doesn't it?!? It's cooling now. I prepared the crust for the last apple pie: This one will be an apple/toasted almond/dried raspberry pie. When that's done we'll have two apples left for baked apples...or, maybe I'll get ambitious and make a small cobbler or apple dumplings.
    My intention, as usual, is to publish the original recipes. In case you're wondering, most of my baking this year has been non-original recipes, followed practically to the letter with minor adjustments for altitude. Since I haven't done as much as I was planning (which is just as well; since we have little storage room I've been giving most of it away) a lot of the experimenting fell by the wayside. I never got around to the fruitcakes, either, although my intention is to make those and get them out for Easter. I didn't even make my famous German Chocolate Chip cookies. I did make a couple of batches of Honey Bear brownies; I need to record the final recipe before I forget it. Anyway, over the next few days my intention is to publish both my mother's pumpkin pie recipe (which is, essentially, a pecan pie within pumpkin custard rather than sugar custard and so spicy it comes out brown instead of orange) and the pumpkin/apple/walnut recipe at the food site under the title, "I Came in on a Load of Pumpkins". I'll be publishing the magnificent apple pie recipes under the title, "The I Hate Apple Pie Apple Pie".
    In case you're wondering, we don't get each other gifts for Christmas. We have so damned much stuff here that we don't need to be buying ourselves frivolities; we usually get a few of those from other's anyway. If there's anything we do need we just get it at the time we think of it. For obvious reasons, as well, I don't feel the need to give the gift of my time to her; I gift her with this every hour of every day. She is beyond giving the gift of her time to me except by simply allowing me free management rein in her care.
    Two people called this morning to wish us Merry Christmas before I arose. Once I arose, I hit the busy button and didn't really want to stop what I was doing to call them back. Besides, this year, Christmas is really quite a wonderful affair for me. I'm feeling good, I'm not being overly hermitic (yes, "hermitic", not "hermetic"), Mom's doing well, and we've both been spending the day in quietly satisfying pursuits: She's been reading and chatting, I've been baking, singing and chatting. This is as close to my preferred way (for details see the first two paragraphs of In the Spirit of the Holiday) of spending the holidays as I can get right now, and I'm satisfied. I know Mom would enjoy visiting but, you know, she's enjoying herself anyway. A short bout of company is scheduled later this week, which should be fun for both of us.
    The Mom is up from her short nap. She's sampling the pumpkin/apple/walnut bread, which seems a bit mild to me but she's enjoying it. It probably hasn't hit it's flavor peak, yet, which is should by tomorrow morning. In just a little bit I'll be putting together and baking the last apple pie. Considering what time Mom arose, dinner will probably happen between 2000 and 2100. It's all going to be extremely easy and flavorful. Perfect way to celebrate the holiday.
    Later.

Yep, it's Christmas.

2005-12-25T10:38:00.001-07:00

    Mom's still sleeping. I'll give her until 1130 or so; that'll be 12 hours. I'm feeling good. We had a congenial, laid back Christmas Eve: Mom and I watched Miracle on 34th Street (the old one) while I baked, then Mom concentrated on a variety of TV Christmas specials while I continued baking. We've already watched It's A Wonderful Life for the season. This year we watched it on a TV channel. Neither of us mentioned that today is Christmas and we're not traveling or seeing family and friends but neither of us denied it, either. I think we're both well satisfied with this holiday.
    Yes, we'll be having a Christmas dinner featuring, yet again, Mom's beloved HoneyBaked Ham, heated in the oven with pineapple slices. Accompaniments: Nuked yams; either asparagus with Hollandaise sauce or a side salad, depending on what Mom's taste is when I get around to preparing dinner; I'll also offer Mom some of MCS's bread & butter pickles, which I'm sure she'll have. Dessert: Probably the pumpkin pie I baked last night. I'm hoping we'll also have home made bread; the bread machine malfunctioned last night and I had to throw out the unmixed, unbaked contents of what was to be a loaf. I'm going to try again as soon as I finish posting here. The older that machine gets, the more finicky it becomes. Sounds familiar...
    Other than being victimized by a fast, furious cold which took hold sometime before I awoke yesterday morning and kept my throat sore and my nose running all day yesterday, I'm feeling very good. The sore throat is gone today; the nose is running overtime. I'm sure this isn't the flu. I'm hoping that Mom's immune system is up to handling my unavoidable spreading of the cold all over our house. She's in very good health, though, so even if she contracts it I think she'll be fine. Although this one doesn't seem to be tiring me, if Mom gets it I'm sure she'll consider it an excellent excuse to sleep, and I'll allow her this.
    Apropos a suggestion by a reader that Mom and I try a spa day: I had wondered out loud (meaning here) at the time if I could handle a trip down to the Valley and back for such an event, even though the event itself sounds promising. Mom would love it and I wouldn't mind it. As chance would have it, while I was doing car-based errands last week and peripherally listening to the radio I discovered that there is a commercial spa facility up here that offers spa-day packages, so I'll be looking into that. I'm very pleased to have discovered this.
    I've pretty much got my network up, tweaked and running the way I want so that I can transfer files from platform to platform. Time for me to finish off the TOC cataloguing and create the index. Don't expect instantaneous performance, though. January is also tax preparation month and my vow is to get everything into Mom's Tax Man no later than the first week in February.
    Today seems to be a decidedly unmusing day. Maybe...
    ...later.

I've posted Mom's current Health Review...

2005-12-23T11:07:00.002-07:00

...which I fax to the doctor every month. This time I posted it for the date of her Blood Draw. You can access it here. I also decided to include it as one of the Special Posts that is listed at the top of the links section at the main journal. Each time a new health review becomes available the link will be changed to take you to the most current version.
    Because I posted yesterday's meals and stats at Mom's Daily Tests and Meds a few hours before she retired, her retirement information for yesterday is as follows: She retired at 2330; light went out at 2345.
    I'll check back...
    ...later.

Did you notice that I linked an essay...

2005-12-22T16:22:00.001-07:00

...to the title This Isn't Your Mother's Caregiving contained in my December 18th post?
    Blood Draw results are up for Mom's 12/21/05 blood draw. Her hemoglobin is heading back up, as are some of her other indicators. She continues to hold her own. I was concerned about her sodium and potassium and relieved to see that those are remaining within normal range.
    I had a very touchy day, yesterday, due to yet more "breathe through your nose, not your mouth" problems in the car on our way to and from the lab. I finally figured out that the only time she consistently refuses to do this to my terrible distraction is when she's in the car. I considered that it might have something to do with car seats but in the last several months she's spent a lot of time in a variety of car seats, thanks to me renting cars for our Valley trips. Of all those car seats only two have been uncomfortable for her or put her in a position that might (and this is a big "might") compromise her ability to breathe normally: Our truck seat and the Monte Carlo seat. The seat she occupied during the Thanksgiving Trip was a very comfortable one for her. So, that's not it.
    A couple of nights ago Mom awoke about an hour into her night sleep, came out to the living room, settled into her rocker with the intention of discussing what one does when one has lost one's driver's license. For some reason she suddenly remembered that she "couldn't find" her driver's license. I explained to her that she no longer has a driver's license and hasn't had one since she drove into the side of our Mesa house in the spring of 2000. We had a conversation about why she no longer drives, including me reminding her that previous to her final car accident she was having trouble remembering how to drive, anyway, would only drive to and from the beauty shop across the street and that I probably should have revoked her license long before I did. I also reminded her of the 92 year old woman in Glendale, AZ, who, the same year Mom drove into our house, mistook the gas for the brakes while at a Park and Swap, demolished a couple of kiosks and killed a couple of people.
    "We were lucky, Mom. All you did was damage our utility room."
    "I suppose so," she responded, "but I think I should have a license."
    "Mom," I told her, "if you want an Arizona ID we can do that. We haven't gotten you one because you have your military ID and that suffices just fine here in Arizona. But, if you want a state ID we'll get you one. Let's wait 'till after the New Year, though."
    "Will I be able to use it as a driver's license?"
    "No, but, Mom, even if you could, I wouldn't let you use it as a driver's license anymore. You haven't driven for almost six years, now, and I'm not about to let you get behind the wheel of a car ever again."
    "Well, I don't know why. I'm perfectly capable of driving."
    "No, Mom, you're not. And, anyway, you never liked driving, anyway!"
    "That doesn't matter! I think I should have a driver's license!"
    "Well, I can guarantee you that the State of Arizona would be in agreement with me, not you. And, anyway, what do you need a license for? I drive you everywhere you want to go."
    "What if something happened to you?"
    "There are perfectly competent ambulance drivers would could take me to the hospital if something happened to me."
    "And what about me?!? How would I get around if you were in the hospital?"
    "Mom, if I were in the hospital you'd either stay with MCS or MFS, I'm sure, until I was able to be with you, again. If I wasn't able to ever be with you again, one of your other daughters would step in." I didn't mention that there's a possibility that she'd be in a nursing home for awhile. No reason to upset her out of turn.
    "I hope nothing happens to you."
    "So do I, Mom. And, frankly, I don't think it will. I think we'll be just fine, you and me, and I'll be able to take you anywhere you want to go as long as you're around."
    "Good. That's settled. I think I'll head for bed."
    Whew.

    I've some more reporting I want to do, but I'm behind on compiling Mom's blood pressure, blood glucose and health reviews for her doctor. I want to get those out tomorrow. Suffice it to say, I've been experiencing a couple of bad days: So difficult that I've been indulging myself in "What if I just decided to abandon my post?" fantasies. Not that I will. The fantasies seem to take the edge off. I'll explain...
    ...later.

Health Review: 12/21/05

2005-12-21T10:42:00.000-07:00

Faxed to Doctor: 12/23/05

Blood Pressure:
    See attached chart. I finally figured out that taking her blood pressure every time she turned around was part of the reason it was running high. Even though it was hard for me, I took your advice to monitor it much less often. I slowly worked myself back to once a day in the evening every other day. Since I’ve been doing this her blood pressure has been very even, no episodes of high blood pressure and no extra lisinopril has been needed. Maybe I was the cause of some of her high blood pressure episodes because I just wouldn’t leave her alone! What a lesson to learn! Thank you, doctor, for encouraging me to pull back in monitoring her. She and I are both much better off for it!

Blood Sugar:
    Very good control. See attached numbers.

Urinary Issues:
    No change. Macrodantin continues to keep her UTI free.

Hydration:
    No change from last month.

Energy Level:
    She’s staying up more than last month. Although awaking later, she’s retiring much later. Her naps are shorter than last month, too. She’s not getting out much more but at least she’s not in bed as much.

Skin & Circulation:
    Both continue to be excellent. No changes.

Appetite & Diet:
    Both remain excellent. No changes.

Dementia:
    Remains unchanged.

Will & Spirit:
    Remain strong and high, respectively.

Medication & Supplements:
    I’ve boosted her, yet again, to 1 tablespoon + 1 teaspoon Benefiber a day.
    She’s had two 200 mg ibuprofen pills in the last two weeks for temporary knee and back aches.
    I’ve given her 20 mg furosemide twice in the last month for torso and feet swelling that wouldn’t go subside any other way. These are noted on her BP report.
    I’ve boosted her lisinopril 7 times in the last month. These are noted on her BP report. All of these boosts happened before I cut back on measuring her BP. Since then, no boosts have been necessary. She seems to be doing well on 10/mg per day administered at 5 mg in the morning and at night.

CHF:
    Only two mild CHF episodes since last report, both involving the administration of furosemide.

COPD:
    No changes from last report.

Bowel Movements:
    One episode of diarrhea after ODing on some diabetic candy. Continues to eliminate every 24-72 hrs; usually every 48 hrs. Fecal consistency, volume and ease of elimination remain excellent overall.

Additional Notes:

I still haven’t found an available flu shot up here but she seems to be doing fine without it, probably because she isn’t getting out much and although I do get out, I managed to get a flu shot before the shortage took hold.
You will notice that a copy of her test results for her 12/21/05 draw are attached (CBC & BMP). Once again, the lab did not delete [Shiny New Doctor's] order from their system and printed the report to be faxed to him. This time, when I picked up my copy and noticed the error, I stood by the computer person and watched as she deleted the order, then had her pull up your order to confirm that they had your new fax number, not your old one. She said she’d fax you a copy of the report but, just in case she didn’t, I’m faxing you a copy with all this other stuff.
Again, just for fun, I did her BP averages for 11/22/05-12/21/05:
pre-breakfast: 133/66 pre-dinner: 127/63
Chances are, now that I’ve slowed down on monitoring, next month the averages will only be for pre-dinner readings. I might, occasionally, do a run of pre-breakfast or pre-lunch readings but the truth is, she is more likely to get irritated when I take her BP prior to breakfast or lunch so I may stick with just pre-dinner readings.
Also, regarding the slow down on BP monitoring, if I notice more CHF episodes than usual and/or her BP seems to run awfully high during a particular reading, I’ll step up the monitoring (a little) to see if anything significant is happening.

Touching Base

2005-12-18T17:07:00.001-07:00

I've got a few moments (which haven't been plentiful, lately). Following is a list of topics upon which I've been meaning to write, but I haven't had much time to get back here; over the next few days, I hope to complete those I don't get a chance to complete at this writing; check back for links to further material on those that are barely more than a title:

I think I have a type of Seasonal Affective Disorder but it's different than the usual.
Happier Holidays than Usual: I've been doing much better at the holidays this year than in years past but not as good as I intended. Once I went to the shed and viewed the work involved in simply dragging a 75 lb box stuck in the back and surrounded by other boxes out and into the truck, not to mention finding all the boxes marked "X-mas" and hauling those out, as well, I decided, nah, I'm not into that this year, we'll use the small fiber optic tree; which, as of this writing, I haven't yet displayed. Maybe tonight.
This Isn't Your Mother's Caregiving: I overheard a conversation at Walmart about a week ago that's been haunting me since. The chattier of the two participants was the married-with-children sister of a woman who, according to the conversation, is taking care of her the two siblings' mother. The conversation involved the listener commenting to Ms. Chatty that, despite not knowing her, she admired Ms. Chatty's sister for "taking on" the care of their shared mother. Ms. Chatty responded, "I don't know if she deserves to be admired. She's not doing anything more than our mother ever did for us when she was raising us." This reminded me of something I read on a website set up by another caregiver who admonished ALL caregivers to consider themselves "heroes", with which I initially took issue and still do but with modifications since overhearing this particular conversation. I'll write on this later.
Linked to essay on December 21, 2005.

For those of you who haven't been keeping up with the minor detail of our lives over at Mom's Daily Tests & Meds, in brief:

We're both doing well;
Holiday baking has dwindled but is picking up again, now that the weather is more to my liking;
Mom still isn't getting out much but it would be inaccurate to say that she's hibernating;
We'll be going in for her December blood draw tomorrow, which will include a BMP and a CBC, both of which I expect to be within her normal ranges;
I've definitely decided, no traveling over the holidays. Despite the promises of felicitous get-togethers, I simply can't face another intense up-and-down trip, right now and don't even want to try;
Our yard is tucked in for a winter that I despair may not appear this year;
My networking effort has been only partially successful but I'm still working on it and hoping for the best;
The TOC is languishing while I spend most of my "free" time on the details of networking the way I want to network.

I'll try to check in a bit more often than I've been doing, lately.
Later.

Appropos what I wrote last night...

2005-12-11T09:21:00.000-07:00

...I thought of the following before I drifted into sleep last night:

Suppose, as a child, you were in a situation where someone other than your parents handled you during the times when maintenance was the order of the hour and stress was necessary? Typically you interracted with your parents when you were likely to be "well-behaved" and your parents (and supposedly you) were "free to enjoy" each other's hopefully stress free company? Rather like an extreme nanny situation? With whom do you suppose you would be most likely to bond? With whom would you have the most life enhancing relationship? With whom would you be most comfortable? With whom would you think you would be most likely to form a deep, complicated, productive love attachement? With whom do you think you'd most likely rather spend time? Who do you think you'd trust in a crisis? Finally, who would you prefer to see first upon awakening and last before slipping into sleep?
If we as a society believe that parents, children and relatives are not only entitled to enjoy the above type of commitment but are better off if they do, what makes us think that our elders "deserve" different treatment from their relations? Why do we insist on believing that the older we get the better off we are in the hands of professionals and potential caregivers are better off if they hand the drudgery over to those paid to do it? If we salute parents and relatives who modify their jobs and their lives in order to care for their children in a committed, loving, all encompassing manner (although, of course, in this nation we do not support them as a society), why do we not also salute family members who do the same in order to take care of family elders in this manner? Why do we, instead, encourage such caregivers to hire out the potentially stressful situations and shrug our shoulders in a "well then, you're asking for it" manner when they refuse to do this?

Later.

Today Mr. Everything worked a morning session for us.

2005-12-11T00:30:00.001-07:00

    I spent a fair amount of time outside with him going over the yard, discussing needs and plans, and talking about some inside maintenance as well. After a Costco run while awaiting the running out of Mom's requested extra half hour of sleep, I was back out in the yard talking with him. Somehow one of us broached the subject of Mom and how she is doing. He's been involved in elder care professionally (interesting that he no longer does this) thus he likes to keep abreast of Mom's life. Today I treated him to a running commentary, while he worked, about what conditions have developed in her elderly body, how we're handling them, talked some about the improvement in her health and the evening out of her life since a year ago September. He and I compared notes on the possibility of trauma, as his wife has an uncle in his 70s who was a robust hiker until he fell during a particularly strenuous hike, broke his hip, and has "declined" since. This is my major fear, I explained, and also why I keep very close tabs on her, practically following her around with my nose up her ass, as she isn't as spry on her feet as she used to be. After this I automatically repeated what I've been thinking since some time before her 88th birthday, that I expect her to live into her 90s and her doctor, too, wouldn't be surprised if she did. Although I thought I'd believed this before this morning, suddenly it hit me, while talking to Mr. Everything, that I am, as of today, absolutely certain that there is no reason for her not to live into her 90s.
    It's curious, really. I had no idea that I'd been voicing this as a hope rather than a belief. I think, sometimes, one has to see one's words hanging in the air between oneself and a listener before being able to evaluate them for veracity. I am relieved to note that this hope of mine is now a belief. As such, I think it will have a subtle impact on my mother's plans for her life span, as well. She is, at this point, absolutely capable of at least two more years. When I think about it, she may very well be capable of a couple more beyond that.
    I'm never sure what keeps her going. Tonight, though, I got a clue. Soon after she retired I heard her sneezing and, as is my habit if I hear any sound coming from her bedroom, I checked on her to see if she was okay. She was still awake but said the only thing keeping her awake was her runny nose. My nose has been running all day, too. Today was unusually warm once it got going, I had more windows and doors open than lately usual and Mr. Everything brought a manual lawn mower over to cut down dead weeds and gather them into piles for our compost bins. I think the stirring up of ready-to-fly pollen and seeds and it's distribution into our house through the open doors and windows is probably bothering both of our sinuses. As well, I noticed on my trip to Costco and back that some indigenous plants which normally, by now, would have died down are sprouting as though spring was coming on. The weather has been unusually warm and dry for this time of year. Maybe the plants are being tricked into thinking it's spring, I don't know. But even some of the weeds in our yard are trying for one more run before the freezing nights tuck them in. Anyway, she and I talked about this, in the dark in her bedroom while she snuggled into her covers. While I was there she sighed and closed her eyes, as though signaling me that she was ready to drop into dreamland. As I headed back down the hall into the living room I realized that one of the factors in her absence of reasons to leave her life is that someone is here, someone intimately familiar with her, who not only keeps a close eye on her but responds to almost every sound she makes, regardless of when she makes it, is vitally interested in every detail of her life and keeps her wrapped in a vital human connection.
    I was immediately reminded of an article I read some months ago in an issue of the New York Times Sunday Magazine entitled: Will We Ever Arrive at the Good Death? In the article one particular woman is followed. At a certain point in her story her family determines that it is necessary to place her in a nursing home. One of their reasons for doing so is their feeling that the stress of taking care of her would lessen their ability to enjoy her and she them when they were together. This particular section of the article has been haunting me, mostly subliminally, since my first reading of it but I haven't taken the time to pull it forward and figure out why. Finally, tonight, it hit me: Although you may think that you and your loved one are enjoying each other when you indulge in short visits and leave the caregiving up to professionals, the truth is that without the detail of daily caregiving, including the "stressful" caregiving situations, you lose out on the intimacy that brings vitality to human connection. Thus, "enjoyable visits" devolve into situations rather like being an acquaintance at someone else's birthday party: Yes, they're fun, yes, everyone is pleased, yes, your literal presence brings with it a gift to the birthday person and yes, the gift is appreciated, especially if you took some care in selecting it. But the party has done nothing to strengthen or deepen your connection to the celebrated one. Once the party's over you remain as much of a mystery to the celebrated as the celebrated is to you. Your presence probably has not contributed much of anything that is more than fleeting to the celebrated person's life.
    If you want to "enjoy" someone, you've got to be there through the parties and the perplexities. You've got to join hands with them during the difficult as well as the easy times. When this happens, the smiles you exchange will no longer be polite and perfunctory, they will be spontaneous expressions of the vibrating connection that indicates you have a hand in someone's will to live and they have a hand in yours. There are few things more important or precious than knowing that someone wants to wake up another day because you will be there when they open their eyes; and wanting to awaken in order to interpret the look in their eyes when they awaken.
    Yes, caregiving involves stress, sometimes insane quantities of it that isn't easily handled and that cause us who care for people with intense needs to stumble as we reach out for our care recipients. Passing that stress off onto professionals, though, means that we also pass off the possibility of deep communion that two people enjoy only when they've been through hell and high water together and have managed to find periods of respite together on a serendipitous patch of cool, dry land.
    Yes, caregiving for an intense needs person is consuming. This is also, though, what makes it an intimate, transformative experience. Refuse the maze of caregiving if you feel you must but keep in mind that if you do you are also refusing much of the amazement.

    There are some glitches in my networking project that I'm having to iron out. Finding periods long enough for the uninterrupted concentration needed has been hard these last few days, so other activities, including up-to-the-minute reporting here, continue to fall by the wayside. I am keeping up with an occasional lag of only a day here and there over at The Dailies. If you can't find a report over here, check over there.
    Later.

Just a quick note to note...

2005-12-09T13:59:00.000-07:00

...that I'm very excited! I was up until 0340 this morning installing and adjusting all the software necessary to network our computers and hook them all to our cable internet connection. Today is Setting Up The Network day.
    Although Mom retired at a normal time for her, 2330, in fact, because she knew I'd be up to all hours fooling with our computers, she arose a couple of times in the night and came out to join me, asking me what I was doing, wanting to see what a computer looked like that was installing a new system on itself, discussing all the cords laying about and the connections I was making from here to there to everywhere. I was surprised at her interest. So was she. Thus, she's still sleeping but I'm going to rouse her in just a few minutes, here, at 1400.
    I'm a bit concerned that she hasn't moved her bowels since her diarrhea. I mentioned last night, as we prepared her for bed, that maybe I needed to administer a light laxative. She said, "Wait until tomorrow. I don't think it'll be necessary by evening." I hope she's right. Neither she nor I like to play the laxative game.
    Time to awaken The Mom.
    I've still got a fair amount to do regarding networking so it may be another 24 hours or so before I post again.
    Later.

The Thanksgiving Drive: Not My Finest Hour

2005-12-08T09:11:00.000-07:00

    By now you know that our Thanksgiving visit was spectacular. Very satisfying for both of us. You know why. What I haven't revealed is the horrible parts of the day, the trips down and back.

Prologue:
    When my mother is on tanked pulse oxygen regulated by her breath she sometimes indulges in mouth breathing for no other reason than that the cannula continues to feel to her like a nose invasion. Her mouth breathing usually occurs when she is uncomfortable, tense (for either good or bad reasons), she has a cold or is particularly weak. When sleeping she uses the concentrator so that if she should begin to mouth breath it won't make much of a difference in the amount of oxygen she receives. Sometimes, if her discomfort or weakness is extreme, I'll move the concentrator around the house and use it on her during the day if she's in need of oxygen. When she uses the pulse regulator I've become so used to listening to the timing of the puffs and reminding her, sometimes as much as a couple of times a minute, to "breathe through your nose, not your mouth" that this chore is autonomic. Thus, she's also gotten so used to me reminding her of this that she relies on my reminders. Somewhere in her mind she knows that if she is paying no attention to her breathing I am and everything will be all right. Lately, within the last couple of months, though, I've experienced blips in which I become irritated with constantly reminding her to breathe through her nose. Thus, I've found it in our best interests, in order to keep the level of irritation to an absolute minimum or stop it altogether, to sometimes use the larger "C" tanks during the day if she's on oxygen and dial the regulator to 2/lpm continuous. I still occasionally have to remind her to clean out her nose and keep her mouth closed when breathing to make sure she gets a full 2/lpm most of the time, but not nearly as often as with the pulse dial settings. When we travel to the Valley and back oxygen is necessary, as her body doesn't adjust well to the changes in altitude anymore and even traveling down to an area where she usually doesn't need oxygen creates a certain amount of stressful breathing until her body adjusts, usually by the time we "land".
    Unfortunately, because I was caught up in trip preparations on Thanksgiving morning (poor excuse, but there you have it), I didn't take any of the above into consideration. When we left the house at 0900 I hooked her up to an M-6 with the pulse regulator at 5/lpm, assuming that this would allow her, between her bouts of mouth breathing, to get at least 2/lpm per minute regulated. We'd gone through all our C tanks previous to the trip and a delivery wasn't scheduled until Friday. The M-6's will deliver oxygen for an hour at most on 2/lpm continuous flow. Even on as high as 5/lpm pulse we get a good three hours out of an M-6 tank, which covers the trip in question. Besides this, since I knew she would probably be doing some mouth breathing, I figured that we'd be fine with just the M-6s going down and up and I knew, since she was in good health, that she wouldn't need oxygen once her body settled itself in the Valley.
The Trips:
    The short version is that at some point after we'd been on the road for a little less than an hour, without notice I fell over the edge.
    The long version: My habit of reminding her to breathe through her nose suddenly morphed from benign and automatic to treacherous and resented. My voice became tighter and harsher. I began to pick on other inconsequential habits she has when we're driving: Balling up the tissues she uses and throwing them on the floor; telling me she isn't thirsty when I remind her to sip from her water bottle and refusing until I order her to drink; repeating over and over that she's "never been on this road before". Within 15 minutes my frustration level was so out of control that I blurted, menacingly, my voice low and loud, "Close your fucking mouth and breath through your fucking nose."
    I hate it when I allow myself to be driven to the point of cursing at her, especially when I use the word "fuck" and its derivatives. However, in answer to Dr. Phil's perpetual question, "And how is that working for you?" the truth is, it worked on the Thanksgiving trip exactly the same way it works when we're at home: Just fine, thank you. Through the rest of the trip I did not have to remind her to breathe through her nose. Problem solved, right?
    Not quite. I was emotionally devastated that I'd allowed myself to devolve to this state and I began to weep silently and uncontrollably. My mother was aware only of the fact that I was stone silent through the rest of the trip. She didn't realize I was uncontrollably weeping, tears streaming down my face and staining the front of my shirt, until we arrived at MCF's house and I pulled off my solar shades, my usual habit before we exit the car.
    I could see her taking note of my state but she said nothing.
    By the time we'd arrived at MCF's house I'd realized that I seemed unable to stop weeping. I decided just before we pulled into MCF's driveway that MCF's sister and her guests would not appreciate a guest who was weeping uncontrollably. When MCF met me behind our car to help me unload the pies I'd baked I sobbed to her that I was completely undone by our trip down, couldn't seem to control myself and that perhaps the best action was for us to deliver the pies to her and head back to Prescott.
    Luckily, she would hear none of this. She and her daughter settled us in their home, took me aside and by the time we all were due to leave for her sister's had managed to help me work myself into a tearless holiday state of mind. They were both completely understanding about the stress I was feeling. Neither of them belittled me or told me to buck up.
    So, we went to her sisters. As you know, both my mother and I had a wonderful time, so good that we promised to come back for Christmas. I gave no thought to the impending trip back up the mountain. There was much help getting Mom in the car, for which I was incredibly appreciative and which put me in an even better mood. I hooked her up to oxygen and off we went.
    Before we were out of the city the trip up had morphed into an extended replay of the trip down with additions: This time my mother couldn't keep her hands off the cannula cording. I found myself not only constantly reminding her to breathe through her nose but to keep her hands off the tubing, as well. My irritation worked itself into distress (without tears this time...I was determined not to inhibit my night vision with weeping) before we were out of the city. Finally I said to her, "Okay, look. I can't continue to do this all the way up, reminding you to breathe through your nose and leave the cannula cord alone. It's endangering my ability to drive safely. If you don't get enough oxygen or you end up disconnecting yourself, oh well."
    She did disconnect herself from the tank during the steep seven mile climb from Black Canyon City to Sunset Point. I could tell because she began to pant heavily. I realized, in part because we were climbing into thinner air and in part because the few cigarettes she'd had throughout the day had somewhat compromised her breathing, that we were going to have to stop at Sunset Point and reconnect her and that it would be best if I suck it up and continue my reminders to her once she was reconnected.
    Sunset Point is not someplace you want to stop on Thanksgiving night. The parking lot was already full of semis and cars nestled in for the night. I drove past all the cars and pulled along the sidewalk on the south side of the rest area, turning on the hazard lights so people would avoid hitting us while I reattached Mom's oxygen and gave her a stern lecture (which, in hindsight, didn't help) about how I needed her cooperation.
    Within a minute after pulling along the sidewalk a DPS patrol car pulled up behind us. "You can't park here, M'am. This rest area is full. You'll have to move on."
    I explained the situation to the officer, telling him that I was almost ready to head back onto the highway. He understood, protected us from the traffic of others driving through the area looking for a place to stop and we were shortly on our way.
    I was fairly successful in controlling my irritation and remaining even-keeled throughout the last hour of the trip but I was miserable. Mom, however, was fine, even though she continued needing reminders to breathe through her nose and leave the cannula cord alone.
    Although I can't say that the trip dimmed the felicitous Thanksgiving get together experience, I realized I had to give serious consideration to how I could avoid some of the tension that we'd both experienced during the actual trip and whether I wanted to do this again on Christmas.
    MCF had offered her home to us, suggesting that we sleep there Christmas eve so that I could have a chance to unwind. I considered ways that I could keep myself from having to remind Mom how to breathe oxygen: The obvious and most promising tactic would be to make sure I brought C instead of M-6 tanks and dial her to 2/lpm continuous while driving there and back. I wasn't sure about the cannula situation but figured I could talk myself into not becoming irritated and simply pulling into the closest exit, reattaching her and continuing, if necessary.
    I also thought about all the work and supplies it would take to spend a night in the Valley with friends: Bringing both regular sheets and plastic sheets; making sure all our bathing supplies were packed for the next morning; making sure our hosts didn't mind if we cleaned out a tank of hot water during her morning bath, a bath which would be necessary; bringing at least three extra sets of clothes, just in case; packing along all the other "just in case" supplies on the out chance that they might be used; performing all the chores I normally do for my mother at home in an unfamiliar environment; packing a futon and my bedding so that I could sleep close to my mother in case she needed to get up during the night in unfamiliar territory; the likelihood that I would get very little sleep and be tired and touchy the next day; negotiating two visits, both of which would be necessary if we were there: One to MPS and her family, since we didn't see them over Thanksgiving (which was a horror of miscommunication all around) and one to MCF's sister's house; all of this followed by the final trip up, when both of us would no doubt be tired and touchy.
    I factored in a few other aspects as well: 5 (at least) tense, possibly horrible hours in the car versus 8 hours visiting on Thanksgiving versus probably about 16 hours visiting over a Christmas trip; the fact that this would be the third trip in less than three months (the first being her doctor's appointment November 1st); the drain on me of taking these trips; the drain on Mom, despite her enjoyment of the visits; my usual heightened tension during the holidays, anyway, not being a holiday person but, at least this year, trying to honor Mom's holiday desires and habits.
    I realized I had a choice: I could try hard and possibly successfully to negotiate yet another holiday trip using all I'd learned from the disastrous part of the Thanksgiving trip to ameliorate any tension problems that might occur, thus honoring Mom and her holiday desires, or I could call it a day, do my best up here in a familiar and relaxed atmosphere to honor the holiday for Mom and hope that, if people want to see us, they work a low-key visit to us into their schedules.
    I've chosen the latter. Most of the time in this caregiving journey I can negotiate tensions without too much of a problem. I'm fully aware of my contribution to any tension I experience and I know how to stop, breathe and evaluate any problems I'm having in order to change course. I also know that when I'm experiencing a particularly tiring and busy period my tendency is to allow my difficulties full sway for at least awhile so that I can observe the onslaught of my strictly emotional reactions without any attempt to reign them in for any reason. The more tired I become, the more likely I am to want to allow myself this sway. I suppose I could use this holiday as an opportunity to figure out how to handle future holidays with much more glee and elan but, you know, I'm already tired, this year, I don't feel like being the cooperative caregiver. I'm already doing a lot of activities I've avoided over the last few heavy-duty-health-negotiation years: Holiday baking and the passing out of home made treats to acquaintances and friends up here; holiday shopping and mailing; focusing on hauling our 75 pound tree and decorations out of the shed and putting it up (which hasn't yet happened but I'm planning on doing soon); making sure I don't hibernate to the point of alienating family and friends...this is about all of which I'm capable this year.
    What it comes down to is this: One can only give care out of who one is. If one is left alone to give primary, secondary and tertiary care without the help of family and community one finally realizes that one can't always take up the slack and remain sane and relaxed. One finally has to chose: Honor family and friends or honor circumstances that ensure one will be remain as sane and relaxed as possible. Once again, this year, I choose the latter.
    Maybe next year.

We had an amazing day, yesterday.

2005-12-08T07:39:00.001-07:00

    All holiday shopping and mailing was finished. Although she had no desire to get out, citing the cold, she was up a lot, felt good and we had a great day. I went over the lists of stuff we were sending to my sisters, which included a copy of the video Antonia's Line. She couldn't remember that she'd seen it so we watched it again, always a pleasure for me. Afterwards we talked about how this close-knit yet amazingly open community of related family and friend family was much like Mom envisions her own family; she being the Antonia-matriarch, of course. Interestingly, there were no regrets voiced about the differences between her actual situation and her imagined situation.
    We both retired at the same time: 2315. I was really tired so I have no idea when her light went off but I suspect it was shortly after I settled into bed, as she was tired, too.
    I will be posting about Thanksgiving: The Down Side shortly. My plan, after that, for today is to update the system on this computer then, set up a wired home networking system that'll allow me complete access, regardless of what computer I'm on, to those aspects of recording Mom's and my journey that I necessarily have to do on Windows software (keeping track of her blood glucose for the doctor). Some parts of the procedure will involve blocks of time during which it would be best if I can concentrate completely on computer stuff and not have to deal with the daily observation of Mom. I should be able to accomplish some of the stuff this morning (like clearing this computer of miscellaneous stuff I don't use and setting it up to easily receive the updated system). Other parts may have to wait a day or two.
    Well, better get on with it.
    Later.

Laid-back day...

2005-12-05T00:12:00.002-07:00

...as you can read in today's Non-stat Day post over at the Test & Meds site. We just sat back and enjoyed each other's company and a moratorium on me chasing her around with the statting meters. Her suggestion.
    Although it's cold, I'm going to try to get her out and moving a little this week on principle, although I'm not sure it will work. I'm not going to push it. I'm past that, now, at least for the time being.
    One of my plans is to hit the storage shed and pull out the Christmas tree and decorations. Time to get those up, clean carpet or not. Our neighbors have trimmed their house with their usual lights and Mom has noticed and admired them through her bedroom window every night before retiring. The background memory of the display keeps her bugging me about "our tree" during the day. It's time.
    No phasing today other than normal short term memory loss. That was a surprise because she was in almost continual memory phase almost all day, yesterday.
    Not much else to report, except all the stuff I've mentioned in previous posts but haven't gotten to, yet. Maybe tomorrow?
    Later.

Thought I'd mention, while I have a few moments...

2005-12-03T16:35:00.001-07:00

...today's Breakfast Stats post contains a rundown about an interesting little phase Mom experienced throughout her "morning", in case you're interested; not too much different than normal, but I concluded from both parts of it that today I'm not one of her daughters, although I'm not sure who I am. At least, during these phasings, I remain familiar to her. That's a relief.
I'm hoping to have some time to report in depth about a few items later today. Despite Mom having a prone day, today (the above post explains why), my attention is turned to a variety of things that need to be done or topped off.
Later.

Yet another advantage of living with An Ancient One...

2005-12-01T16:03:00.002-07:00

...is that certain movie reviews come into sharp perspective because of the constant stream of Animal Planet and National Geographic programs flowing through one's home. Day before yesterday the much awaited by Mom movie March of the Penguins arrived in stores. I had to make a supply run to Costco and picked up a copy of the movie. I noticed the blurbs on the cover, "Astonishing! Unbelievable! Riveting! Amazing!" and thought, whoa, this must break new ground in animal films. Well, it doesn't. Although we will keep the film because Mom found it as entertaining as watching the two aforementioned channels, by the end of our first viewing Mom thought she was watching television. Nothing about the movie is astonishing, unbelievable, riveting or amazing to anyone who watches animal programs regularly on television, including the excellent narration by Morgan Freeman, the mind boggling photography, the story of the life cycle of Emperor penguins, the landscape footage, nothing. I'm surprised that film critics across the board seem to lack exposure to animal footage and filming techniques. While it's true that filming in Antarctica, one of the top few harshest environments on earth, had it's special challenges that allowed for the invention of groundbreaking filming techniques, if you watch animal shows regularly you are aware that every wild environment has challenges that require photographers to invent and adapt and reconnoiter their equipment on the spot.
    Today's Breakfast Post contains a rundown on a recent injury I sustained and my mother's and my efforts to live through the healing. Although telling about it was prompted by my mother's blood pressure this morning, my mother's reaction to my injury all day yesterday and today has rent my heart. This part I didn't talk about at the previous post. I empathize to the nth degree with her fears. Despite her independent spirit, she is, now, extremely dependent on me physically. When I can't squat and rise, thus turning bathing into something of a physical comedy routine, when I autonomically wince going up and down our steps, when I know better than to try to bend my right leg into the position required to drive, thus can't, for instance, pick this or that up from the store at my mother's request and when I am overly cautious with my mother when she moves around because I'm using the knee bandage instead of her (this episode has taught me that we need two) and I want to make sure that she doesn't do anything that might cause her to fall because I wouldn't be able to squat to lift her off the floor, all of these contingencies bring into laser-sharp focus how much we both count on me to remain healthy and free of injury. Even, as in this case, when I know that within a few days I'll be good as new, my mother experiences anxiety over my temporarily lowered ability to tend to her in a care-free (hyphen important) manner. This, in itself, is an excellent reason for our society and others who are currently ignoring their Ancient Ones and those who take care of them to turn in on themselves and consider how important it is to incorporate those in the advanced stages of aging into some kind of a framework that does not allow for the intense isolation most caregivers now experience. While there are some (on the lower end of "some") resources available, while there are pockets of different cultural communities here and there in our nation that silently require all their members to incorporate their Ancient Ones into a strong caring and support network, for most of us caregivers in this nation (including parents, by the way) support requires that we do the footwork. Unacceptable. When one's feet are positioned firmly toward an intense needs Ancient One, attempting to turn toward support often causes us to loose our footing with our Ancient One and someone risks, well, a knee injury, figuratively and sometimes literally.
    While I'm on the subject, although I know caregiver support groups function well for some people, let me tell you why many of us caregivers don't "take advantage" of these opportunities. One reason: When I can maneuver a few moments to myself the one thing I don't want to do it focus on caregiving. I don't want to focus on anyone else's caregiving and I don't want to focus on my own caregiving. I always have it in the back of my mind, anyway, even if I am doing something that appears not to be related. I certainly find it therapeutic to write about my experiences here; I even relish the opportunity and miss it when I can't "get back" here on my fairly regular schedule. When I'm with other people, though, even caregivers, I don't want to talk about caregiving. I want to hear and ask questions about someone's recent brain surgery, as I did the other day. I want to joke about almost anything except caregiving. I want to hear political and spiritual opinions, especially those with which I don't agree. I want to notice someone's jewelry and comment on it. I want to relate the story of my many-be-earringed ears. I want to laugh with a stranger in a parking lot over a bizarre bumper sticker. I want to fuss and flirt and engage in fanciful talk. And, I do. I do not, I repeat, I absolutely do not want to talk about caregiving, unless it's with people like my treasured Fed-ex delivery lady with whom I've forged a share-stories-of-taking-care-of-parents relationship. Although I suppose this could be considered a type of caregiving support "group", it is completely informal and we talk about other things. As well, she and I are honed in on each other and only each other when we cross each other's paths. Since our "meetings" aren't planned there is always an element of delighted surprise when we get a chance to chat. We both turn back to our lives feeling revived. And, we don't have to practice polite and often fake compassion for several other people while we are indulging in real, focused compassion for one another. Finally, our meetings usually take place when I am in the middle of caregiving. Thus, I don't have to set aside precious "time for myself" in order to talk and listen about caregiving.
    For caregivers like me, and there are many, communicative caregiving support works best (for lots of reasons) on an informal, day-to-day, surprise level.
    The Mom's up from her nap.
    Later, by surprise.

Something I've been meaning to mention for over a year...

2005-11-30T00:34:00.000-07:00

...an interesting little Dementia-Lite glitch.
    When my mother was in the hospital and skilled nursing facility last August I removed all her jewelry, which included her engagement and wedding rings. The day she left the skilled nursing facility I brought these items with me so she could leave fully bejeweled. She put on all her jewelry herself. A month or so later I noticed that when she replaced her wedding rings she put them on her right hand. I mentioned the discrepancy to her and, said that I found the misplacement interesting because in some cultures when someone is widowed they move their wedding rings from their left to their right hand.
    She was startled; not that I reminded her of Dad's death but that I thought her rings were on the wrong hand. Not only did she insist that she had placed them correctly, she "remembered" that the rings had never left her hand "since the day your father put them there" and that she had worn them in the medical facilities. Although this particular pair of rings is her second pair, the "upgrades" which my father purchased for her on Guam several years into their marriage, and, as well, every time she's been hospitalized since we've been living together I've been entrusted with keeping her jewelry, I didn't argue.
    To this day, her wedding and engagement rings remain on her right ring finger.

Just wanted to check in...

2005-11-29T09:44:00.001-07:00

...and let you know that I'm hoping to do a catch-up post here later today. Aside from being pretty busy the last few days, I've also been engaging in some deep thought prompted by our Thanksgiving adventures and misadventures. I wanted to work my way into my usual less removed state before I wrote about what happened and my reactions.

    I've been adding minor detail about our days over at Mom's Daily Tests & Meds if you want to check up on how Mom's been doing.
    Must take a short shopping trip.
    Later.

The visiting part of our Thanksgiving trip was super-splendid.

2005-11-25T13:57:00.001-07:00

    Mom and I, separately and together, had a wonderful time with MCF and her extended family (and friends), who are marvelous hosts and know how to do a in-and-out door, watching-football-and-visiting Thanksgiving get together. As well, as you may remember, this was the family of MCF, who took care of her Ancient One father until his death. All their family, while still sometimes frustratingly unavailable for MCF, were much more available than my family is (not calling a fault, just stating the truth, mind you) for me, so everyone involved in the family who was present was auto-tuned to my mother as An Ancient One and, while I was also well tuned to her, I was able to relax. My mother shimmered and shone, as usual, made a new friend and spent the afternoon developing all kinds of plans for our yard based on what this family did with their yard. Today she continues to talk about various aspects of the get together in glowing terms.
    A bizarre glitch occurred on our trips down and back which I almost allowed to take us out of the running for the gathering, but somehow MCF and her daughter came to my rescue lickety-split when we arrived, which I wasn't expecting, and saved my and my mother's day. I'll explain later. There is more to tell about the party, too, and some hard caregiver realizations I had, but I'll discuss those, as well...
    ...later.

Traveling with you in your Ancient Years is all about just-in-cases, Mom."

2005-11-23T22:52:00.000-07:00

    This was my reply this evening to her comment that the list of things to take on the trip tomorrow, which she insisted I read to her (as self-elected Trip Supervisor she demands that I keep her apprised of all activities and preparations leading up to trips) as we contemplated tomorrow's journey, had "an awful lot of just-in-case items on it."
    She's having a little trouble remembering that it's Thanksgiving (which is fine with me, my preference is to forget holidays) and who we're visiting but becomes excited all over again when I remind her. If you don't like holidays and have to do them anyway, it's best to do them with someone who's resume includes a long stint as Mrs. Holiday.
    When I confirmed that Ancients seem to specialize in "just-in-cases", she laughed and said, "Yes, that's part of the fun of getting old," without irony, I might add, which surprised me. My mother is nothing if not ironic and never passes up an opportunity to acknowledge genuine irony.
    Gotta love that woman's spirit.
    I'm pleased with the products of my baking, today. Everything came out of the oven without hitches. I won't be able to treat the cheesecake to it's preferred 24 hours of refrigeration before serving but I think it will be scrumptious anyway. The pecan pies were a breeze. Too bad I don't like the idea of pecan pie. Mom was so taken with the results that at one point this evening she arose from her rocker and headed into the kitchen.
    As per my usual precaution, I asked, "Where are you going?"
    "To get myself a piece of pie," she said.
    "Whoa, whoa, whoa! No you're not!"
    She took offense. "Why not?!?" she demanded.
    "Mom, let me put it this way. If you take a piece out of either pie or the cheesecake before we deliver them to MCF tomorrow and I'm forced to either bake another or show up without everything requested, I'll never forgive you."
    She did a double take. I rarely express myself this strongly to her. "Well!" she said. "I'll have to wait with the rest of them, is that it?!?"
    "That's it, Mom. Said and done."
    "Such a shame to let those pies go to waste."
    "They won't be going to waste! You can have a piece of all three of them tomorrow after dinner! I promise!"
    "You can be awfully snippy when you're baking, you know."
    All I could do was laugh.
    She headed back to her chair, still nursing a snit. The pies will be well hidden tonight before I go to bed. Not that I expect her to awaken in the middle of the night and rummage through the kitchen. But, you know, just in case...
    ...later.

I feel as though I am, oh, say 9 or 10...

2005-11-22T23:59:00.000-07:00

...and tomorrow is a holiday, which is synonymous with no school, so I can stay up as late as I want, relax, do whatever I want, sleep in tomorrow...I'm even drinking coffee tonight, at this late hour, so I can enjoy the evening and myself into the wee hours.
    The two pies I'm making tomorrow are pecan; one is chocolate pecan. That's what was requested. I've purposely shied away from pecan pie: No fruit, seems like it's just pecans and sugar; I prefer my nuts straight and my sugar very light. Preceding the two recipes I found in Joy of Cooking, though, was the following blurb: "The filling of pecan pie is actually a sort of custard composed of sugar, butter and eggs..." Ah, I'm thinking, custard. I like the challenge of cooking an interesting custard. I also like the challenge of making food that I would not normally eat, just to see if I can do it well. The pumpkin cheesecake, of course, is something I love, so that will be fun to make. Mom will busy herself supervising, as she loves to do when cooking and baking are being pursued in the kitchen.
    I think I'll put some more cataloguing under this journal's belt tonight.
    Later.

Although she was feeling good when she awoke...

2005-11-22T15:40:00.000-07:00

...this morning and awoke on her own much earlier than the last few days, she wasn't up to a trip to the grocery for supplies for our pie baking spree tomorrow. This worked out well. The grocery was so crowded that aisles were regularly blocked and the deli area, where she would normally sit out a busy market, was chock full of companionated people with the same idea. She did, however, remain awake of her own accord while I shopped, looking through our selection of cooking magazines and watching Animal Planet.
    I'm thinking, so we don't have to get an unusually early start on Thanksgiving, that we'll probably sack our first visit plan for Thanksgiving Day which involves visiting relatives for brunch. I think Mom's going to be moving slow. I talked to MPBIL early today about this and he understands. He's enduring a sinus infection and MPS has a stubborn cold. If we don't make it for brunch at their house I don't think it's going to be a problem. I think the day will be easier on both Mom and me if we don't try to hit the trail at 0700 and accomplish a lot in a short amount of time. MCF's family may as well consider themselves our family, anyway, so we'll definitely be celebrating with family.
    On the holidays I much prefer visiting to hosting, now. The amount of work remains the same either way, really, although the type of work differs. When visiting, I hone my attention more acutely on Mom by a power of three; when we're hosting it's by a power of two. Juggling all the supplies with which we travel is worthy of a Las Vegas acrobatic act. Unfamiliar surroundings mean that I have to be aware of where she is at all times, what she's doing, be ready to help her negotiate her way around an unfamiliar environment and try to anticipate what she might do next. When we're hosting all the extra work involved causes my temper to wind tightly from trying to keep everyone from "helping" me into a lot more work than is normally necessary. When people (family, actually, related family) visit for the holidays there is a silent assumption, which I have to fight, that all the routines, restrictions and reminders that keep Mom in peak condition can be dispensed with. I end up countermanding everyone's else's assumptions about what Mom can/should and can't/shouldn't do. When we're visiting, hosts tend to step out of the way and ask me first if this or that is okay for Mom. I'm not sure why this happens but it does. Although either way it's a trick for me to relax for moments here and there and enjoy the company of others on holidays because of keeping my eye on Mom, it's definitely easier when we're visiting.
    Truthfully, visiting MCFs is always easier on me than visiting related family. The reason, I believe, is because they took care of their elderly father in their home for some years up to his death. They get it. They get everything about it, including all the peculiar-to-holidays caregiving challenges. They've developed the eccentricities of the senses that caregiving for An Ancient One catalyzes. They understand that I'm going to have my primary sites constantly on my mother and they instinctively pitch in. I know that if I don't notice a possible haywire moment they will. Thus, I relax more around them.
    As well, this holiday none of them is sick. This bodes well for Mom.
List of stuff to take:

Plastic sheet in case Mom decides to nap (unlikely but it's a good idea to be prepared).
Lots of paper underwear, both sizes.
Mom's favorite brand of diet rootbeer.
My bubble water.
The flavored faux creamer that I contiually forget to give to MCF when she's here.
The pies and cheesecake.
The whipping cream for the pies (check with MCF on this).
Two gallons of water just in case (always a good idea in the desert).
Change of clothes for Mom, just in case.
Mom's meds.
Baby wipes, just in case.
The back dated gossip tabloids we've collected for MCF and family.
Two M-6 canisters and one C-4 canister of oxygen, just in case. She probably won't need oxygen down there but you never know.
The walker. I think we'll be able to do without the wheelchair. If we take the cane Mom won't use it. She hasn't gotten used to it yet.
A can of V-8 juice and maybe some yoghurt for Mom to snack on, just in case there is a long time between major feeds and she gets hungry.
Big ice chest for the water and spoilable food. Oh, yeah. Gotta remember to get ice. Maybe we'll do that on the way out.

I think that just about does it.
Later.

Speaking of blood pressure...

2005-11-21T23:45:00.002-07:00

...I decided to establish a permanent link to the Blood Pressure Average post I put up over at Mom & Me Daily Tests & Meds on November 3, 2005. Because Mom's lisinopril dosage was doubled at her last doctor's appointment (11/1/05) I was curious to see how her average since that date compares with the last few months, when I'd been freaking about her blood pressure. The results assured me that doubling her lisinopril dose was a good idea. I realized that averaging Mom's BP readings is a helpful tool, so I'm going to continue to calculate it every time I write up a health review for her PCP and add each period's averages to the list. The permanent link will remain over the right in the list of links.
    The adult buffered aspirin I gave her tonight (read about it over at tonight's Dinner Stats post) seems to have done the trick. She arose about 15 minutes ago wanting some coffee and "to sit up for awhile". She's watching Animal Planet, not doing any mouth breathing, she is coughing a little here and there but she feels good.
    Tomorrow is a No Excuses Day. We've got to pick up the ingredients for the pies I'll be providing for the Thanksgiving Feast to which we've been invited. I don't know if Mom will be up to going along, but she might. It'll be warm and sunny tomorrow and the weathercast mentioned nothing about wind. We'll see. Although I wondered if we'd make our Thanksgiving plans when I posted her Dinner Stats tonight, I'm more optimistic, now.
    Later.

It's that time of month, again...

2005-11-21T23:09:00.000-07:00

...for Mom's health review on the occasion of her monthly blood draw:

Blood Pressure:
Doing okay, as you can see by the chart. Splitting the 10 mg lisinopril tablets in half and giving them to her in the morning and evening seems to work best for her. Last week her BP took a slow climb up until, on Saturday evening, I noticed that she was retaining some (not a huge amount) of abdominal fluid (although her feet weren’t swelling). I gave her 20 mg furosemide and an extra 5 mg lisinopril that night. She shed all excess water over the next 24 hours and her BP has settled down, although I’m keeping my eye on her.

Blood Sugar:
Very good control. See attached numbers.

Urinary Issues:
No change. Macrodantin continues to keep her UTI free.

Hydration:
No change from last month.

Energy Level:
After a long surge of active (for her) days, the last two weeks she’s been slow and tired, sleeping a bit more than usual. Her blood draw tells me it might be because her hemoglobin was falling a bit. It goes up and down, though, and her hemoglobin isn’t out of her normal range so we’ll just go with it.

Skin & Circulation:
Both continue to be excellent. No changes.

Appetite & Diet:
Both remain excellent. No changes.

Dementia:
Remains unchanged.

Will & Spirit:
Remain strong and high, respectively.

Medication & Supplements:
I’ve boosted her to 1 tablespoon Benefiber a day just recently as her body gets used to it. Other than this, on 11/18/05 I gave her one 200 mg ibuprofen because she was complaining about her knees. On 11/19/05 I gave her an extra 5 mg lisinopril in the evening besides her usual evening dose and 20 mg furosemide to rid her of some fluid retention. Other than these there have been no changes in her medication since her appointment on 11/01/05. I haven’t yet located a flu shot for her. Still working on that.

CHF:
Apparent CHF episodes and wild BP have both calmed down since last report.

COPD:
No changes from last report.

Bowel Movements:
No constipation or diarrhea this period. Continues to eliminate every 24-72 hrs; usually every 48 hrs. Fecal consistency, volume and ease of elimination remain excellent overall.

ADDITIONAL NOTES:

In retrospect over the last five days or so, I think her body’s been fighting a cold but it’s been handling it so well I didn’t pick up on it. I took her temperature tonight (11/21/05) because she felt warm. Arterially on the forehead it was 100.9°F, which is .7 degrees above the cut-off for normal range. I gave her a buffered adult aspirin with water while she still had food on her stomach and before she retired. I’m not worried, I think her body is fit to handle this.
Also, just for fun because of your mention of BP averages at Mom’s last appointment, I set up a spreadsheet to calculate average BPs by month and time taken for as far back as I have BP numbers. I thought you might find the following interesting:
- November breakfast BP average: 121/65
- November dinner BP average: 128/59
Her systolic is doing better on the higher lisinopril dose compared with:
- October breakfast BP average: 131/64
- October dinner BP average: 139/66
- September brakfast BP average: 125/63
- September dinner BP average: 131/63
I think it was time, at our last appointment on November 1st , to double her lisinopril dosage per day.

Well, I did it.

2005-11-21T16:14:00.002-07:00

I sought out the proper contact at Revolution and sent a lengthy email detailing my thoughts about Medical Advocation and what I would seek from such a professional. I cited my experience as my mother's avocational medical advocate as proof of my knowledge of the subject. I included the text of three posts, the beginnings of which are listed below and labeled as they were in the email:

    I concluded with mention that I felt people interested in forming a company designed to provide medical advocates would be interested in "'from the front' information about what would be desired by patients from such professionals and patients' fears about what might 'dirty' the profession."
    In less than an hour I had a preliminary response from the woman to whom I directed my message. She assured me that she had passed my message on to someone in charge of that area of Revolution and would leave it up to that person whether to contact me further.
    It was, of course, a polite, perfunctory response. I hadn't expected any response except maybe an auto-e acknowledging receipt of my message, so I was encouraged. Neither am I hanging on the possibility of further contact. As I explained to my mother when I told her what I did, considering the detail and coverage of my message, further contact is moot to the reality that anyone who is involved in the establishment of Professional Medical Advocates, whether they have personally advocated medically on behalf of someone either professionally or avocationally, will not be able to forget what I wrote. It can be consigned to a back file, a circular file, whatever. It will not leave their mind as they proceed in their creation. This is the most important aspect of what I did. I hope it will help. There is no reason why it shouldn't.
    I will, of course, mention here any further correspondence if it occurs.
    Later.

Blood Draw Test Results are up...

2005-11-21T09:22:00.003-07:00

...for 11/18/05. Her hemoglobin is lower than I expected but still within her range. Although there aren't any tests for this period of time last year, her test for 9/02/04, while still in "the nines", is even lower than Friday's draw results, so I'm okay with her readings.
    I ran into a laboratory glitch this morning. It seems that they still have the old prescription from her old office and The Shiny New Doctor who dismissed us in their computer and faxed "the doctor" off that old prescription. I faxed her current (and constant) PCP this morning with the lab results, as they hadn't received a copy, and called the lab to change that information. They were swamped. "The front desk" didn't answer the phone so I was told to call back in the afternoon. Yet another medical administration disappointment. If you readers think you can get away with Medical Advocate-Lite status if you are managing the health of a loved one, think again. At this time, chaos reigns in in every corner of the medical-industrial complex.
    Which reminds me...a few days ago I ran across my posting about Steve Case's Revolution venture into medicine, including his desire to create a company of medical advocates. In that post I mentioned that I planned to comment on his commercialization of medical advocacy. I never did. This seems a good time to do it.
    Although I think commercial medical advocacy is an excellent idea, I worry that commericializing medical advocates for patients may devolve into medical advocates being curried by doctors to the point of actually advocating for the medical-industrial complex instead of patients. I have visions of a professional medical advocate for my mother, for instance, responding to me much the way MPBIL, who is a social worker as a patient liaison in the transplant field, did when I was in a quandry about whether to allow my mother to be colonoscopized: "It's standard, now. Everyone gets one just for history. Trust the doctors regarding her risk assessment." I was both surprised by and suspicious of his advice but, as you know, several months later I was finally beaten into agreeing to the colonoscopy. As it turned out, the gastro-enterologist who performed the procedure (and who I was supposed to trust regarding risk assessment) admitted that the procedure had been a bad idea and Mom should never again be scoped, she was too old and frail and the procedure had been "torture" for her.
    Obviously, medical advocates are going to need to be trained (hopefully highly trained). Commercializing medical advocacy will probably and inevitably mean that their training will be institutionalized through the medical-industrial establishment; including doctors, nurses, facilities, drug, insurance and equipment companies. I shudder to think what this could mean for their ability to advocate on behalf of their clients.
    In my ideal world medical advocates would be not only highly trained but highly aware of the constant, myriad blunders the medical-industrial complex stumbles through on behalf of patients and the reasons for such blunders. Although it would be important for some of their training to be directed by the medical-industrial establishment so they were thoroughly familiar with this section of medicine, another part would involve alternative training which would make them aware of such problems as:

The tendency for doctors to support one another's diagnoses rather than their patients;
The likelihood that drugs and procedures might be encouraged on the basis of the vociferous lobbying of drug and medical equipment companies rather than the needs of their patients;
The certainty that, with the current "get 'em through and get 'em billed, as many as possible" climate infecting medicine right now, many doctors, even those of long standing patients, are not making accurate diagnostic, prognostic and prescriptive decisions based on a patient's history because they don't have the time or motivation to check those voluminous histories they collect on their patients;
The fact that understaffing in both hospitals and clinics increases the likelihood that any particular patient will not receive top-notch treatment in any medical facility and mistakes will be made regularly in such areas (all areas of which my mother has experienced medical mistakes) as:
- diet prescribed for a hospital stay;
- inattention to skin tears from the attachment of IV supplements;
- extreme bruising of diabetics' fingers when blood glucose levels are taken;
- misreading or ignoring of prescribed treatments;
- prescribed treatments being abandoned after a discussion with medical advocates then represcribed by an ignorant staff doctor who disdains medical advocacy;
- lists of medications that are solicited from the patient and/or medical advocate being ignored;
Lack of attempt at reasonable risk assessment being passed off as adequate risk assessment;
Physicians and nurses being unprepared for visits with patients;
Physicians taking offense at a patient's or medical advocate's questioning of and/or denial of prescribed treatment and dumping patients rather than considering and respecting the patient's/medical advocate's research and opinion.

As you know, I do a great deal of medical advocacy on my mother's behalf. I would, however, love to be able to access the services of a professional medical advocate. If I could, this is what I would want from and ask of such a professional:

I would use the professional to back me up with the ability to perform and produce all-inclusive, up-to-the-minute research on all my medical (including alternative medical) questions and problems. My expectation would be that the professional would have this access and know how to hone research to specifics quickly and with little fuss.
In disputes with physicians and other medical personnel I would want my professional to support me with reasonable back-up, which includes being able to trust that professional to determine, with complete information, when I was misguided or wrong.
I would want my professional to be up-to-the-minute on all medical facilities and personnel appropriate to my mother's care in our area and available specialists-of-interest in other areas in case I need an unbiased second physician's opinion or need to hire a medical and/or therapeutic specialist, etc.
I would want my professional to be familiar with the eccentricities of my mother's medical profile, including my own difficulties with the medical-industrial complex, and have this information finger-tip available so that I knew I could trust their personnel refreshment from patient to patient.
I would want my professional to be able to translate technical medical language, including test results, for me into terms I can understand and use.
I would expect my professional to have alternate ideas on diagnosis, prognosis, treatment and the handling of my mother's medical care and be responsive to my requests for such.
I would expect my professional to advocate on my behalf in the tug-of-war to have access to as much medical information about my mother as I deem necessary at any particular time.
I would expect my professional to be thoroughly aware of the ins and outs of all my mother's insurance plans and be able to answer questions about coverage and availability almost as quickly as I asked them. I would also want my professional to act as a reminder when I need to perform insurance recertification procedures for my mother.
I would want my medical advocate to be familiar with the down side of her insurance plans (i.e., when doctors give me lectures about "Medicare in rural communities") and have suggestions on how to affirm and/or counter such down sides.
If I have legal questions or concerns about my mother's medical care I would expect my professional to pay attention, inform her/himself of the possibilities, speak to me about such contingencies from our point of view as well as medicine's point of view and, in the final analysis, be able to advise me wisely and from the patient's perspective on whether to initiate legal action.

Hmmm, I wonder if Steve Case would be interested in my opinion. I think I'll check his site to see if there's an email address to which I can send the above posting. I'll report back...
...later.

Forgot to mention...

2005-11-20T23:09:00.001-07:00

...blood draw results will be up tomorrow, so will her monthly (or so) health review that I'll be faxing to her PCP.
    Also, she and I watched TCM's presentation of Sense and Sensibility. Although I expected that my mother would shun it because of the English accents and my suspicion was further endorsed because the station forgot the Closed Captioning until half way through the movie, my mother was as taken with the production as I was. By the time the toward-the-end scene occurs when Elinor breaks down crying and laughing at the return of Edward we were both laughing and crying, and thoroughly satisfied.
    Before I could saying anything, Mom said, "If you see that movie anywhere, get it. I'd love to see it again."
    Funny, they've had it at Costco regularly, it is now much reduced in price there, but since I hadn't seen it and am careful about Jane Austen adaptations I hadn't picked it up. I will, now.
    Maybe she's ready for some of the more flourescent productions of Shakespeare, like Branagh's production of Othello with Laurence Fishburne or Polanski's MacBeth. She tends to find the BBC productions too hard to follow, but some of the "made for the popular theater" productions might appeal to her. I know, I was blown away that she enjoyed BBC's Pride and Prejudice.
    Later.

Much of Mom's day...

2005-11-20T22:34:00.002-07:00

...centered around her body's recovery from the furosemide flushing that I initiated last night. Those details can be accessed at yesterday's and today's posts at Mom's Daily Tests & Meds. The flushing and replenishment of fluids, along with some extra Benefiber®, caused her to go through a typical wrung-out-rag to moderately-moisturized-rag episode that happens when I flush excess fluid off her. It was hard, this time, to tell that she was retaining water. The process happened slowly, over the last week. I'd examine her every morning and every night and she would seem fine to me in the context of what I'd seen the day before, so it sneaked up on me. I'm hoping this is an isolated episode. I don't want to be administering furosemide to her on a regular basis unless the alternative is much worse. As I mentioned to her this morning, furosemide really takes the stuffing out of her.
    Yesterday was dominated by Mr. Everything's first visit of the season. There was a lot of yard clean-up for him, some electrical work inside the house, and he worked like a Mr. Clean demon. He finds it hard to accept that I don't want the yard whistle clean, that I want dying weeds and stuff left where they are and that I appreciate the large, unruly kindling pile in the back as what it's become this fall, an "apartment house" for a large number of Gambel's Quail, wood squirrels (which used to take up residence in our crawl space and between the walls of our house, harvesting insulation for their nests) and grey squirrels. Our property is a happy home for hundreds of small creatures, earthbound, airbound and inbetween, and I like keeping it this way. In order to do this properly, I think, the best way is to allow some "mess" (not as much as usually piles up in our yard) and a distinct lack of strict domestication. I explained all this to Mr. Everything yesterday and he's beginning to get it. I know it's hard for him: His father-in-law owns a local landscaping company, from which he learned this particular trade, so it's hard for him to accept a wild yard.
    Mom awoke early (for her) yesterday because she was excited about watching Mr. Everything work. As he moved his work into and out of the house she chatted with him. The big event was the removal of the dying ornamental plum tree directly in front of our house. Although he decided to leave the roots in because he noticed that the tree, as he was cutting it away, was disintegrating from the inside out, thus the roots are not bound to revive, he cut it off deep below the soil line and restored the retained area so that you can't even tell a tree was there.
    Today was a slow day for Mom, recuperating, as she was, from flushing. It went well, though, and she was in an excellent mood. I started her out on oxygen, as she's been using it a lot through the day lately (which is a change from about a week and a half ago). She became irritated with it, though, and took the cannula off. I waited to see if she was going to mouth breathe, as she's been doing this a lot lately. She was fine, breathing normally through her nose all of the afternoon and evening that she was up. I let her sleep in today, as she was up at least twice in the night peeing (because of the furosemide, I'm sure), and was resting nicely this morning. I became nervous, though, around 1300 and awoke her. She had slept herself into a stupor but once we got her going she was fine, and thirsty.
    When I mentioned, tonight, that I need to buy supplies for pie-making for our Thanksgiving visits she expressed interest in going along. This, in itself, is the best sign. We'll see, of course, but she's excited about Thanksgiving and the trip. I'll keep my eye on her to make sure that we nip any signs of continuing torso fluid retention in the bud and she enjoys an alert, energetic holiday.
    When she retired, tonight, I mentioned to her how good she was looking and that I thought we'd negotiated the fluid retention problem well.
    "I was retaining fluid?" she asked.
    "Yeah, but I didn't understand what was going on until yesterday, because it happened so slowly this time. I gave you a 'water pill' for it last night and that's why you were so tired today; I flushed you out. That's also why you had a meal so high in sodium and potassium things tonight."
    She shook her head in amazement. "You mean you actually take all that into consideration when you feed me."
    "Oh, yeah, Mom. With every meal. Nothing goes into your mouth that I haven't already calculated from a nutrition and body effect standpoint. I've been doing that for at least half the time I've been with you, so that would be, hmm, about five and a half years."
    She thought for a moment. "You've been with me for eleven years?!?"
    "Yeah. That's right."
    "Goodness! It doesn't seem possible!"
    "Well, it is."
    "Well, I hope you plan to stay around. You know how I am about meals on my own, I just eat whatever's handy, whether it's good for me or not, whether I like it or not."
    "Well, that hasn't been necessary for a long time, and it won't ever be necessary again."
    "So, you've decided to stay?"
    "Yeah, Mom. I'm staying. I'll be here for the rest of your life."
    "Well, good. I've never eaten better."
    It's the little things...
    Later.

I'm catching up to myself.

2005-11-19T00:28:00.000-07:00

    I'm speaking of the cataloguing of links for the dynamic index. I'm halfway through August of this year and it's going pretty fast, now. I imagine I'll be able to start dynamizing the index and setting up a page for it within a few weeks. I'm not going to read through the rest of the journals that might contain material that should be indexed until I've set up the Table of Contents for the main journals.

    For the last several months I've moved my "bed" (which exists in a variety of disguises depending on which futon I'm using or where I'm sleeping) in front of the back Arcadia door, between it and my bedroom door. This allows me complete hearing access to the hall so that I can hear Mom get up in the middle of the night or, if necessary, hear any unusual sounds in her room. As my mother headed down the hall for her nap, today, she stopped just before her door, gazed into my bedroom and asked, "Your bed looks soooo comfortable! May I take my nap on it this afternoon?"
    My bed is as comfortable as it looks. It's probably the most comfortable bed in the universe. It's current base is a single futon. That is covered by a full feather bed. I sleep under a winter-strength down comforter. Above this is a thick, king size Italian wool spread with which one of my sisters gifted me. Over this, for the convenience of The Little Girl and because it is a family heirloom, I've thrown a thin, odd-sized chenille spread that came to us from my father's side of the family in North Carolina. It apparently belonged to my fraternal grandmother and was sent to us as a keepsake some 20 years after she died, when they finally cleaned out her attic and sold her home and land. My head is cradled and my hands are warmed by five down pillows I've collected throughout my life, one of them having been owned by my favorite maternal uncle's wife. Another I've had since Guam. One of the pillow cases I use was one my father used when he was bedridden before his death. The entire production of my bed is deliberate, warm and wraps me in family when I sleep.
    My mother knows all this but most of the information she phased out long ago. So, I assured her that my bed is, indeed, the ultimate in comfort. I recited the history of my bedding. Then, although I would have loved to have let her sleep in it, I denied her request.
    "Mom," I said, with regret hanging off each syllable of what I said," I'd love to let you sleep there. I won't be using it for a nap. But if you lay down at floor level, even though under duress we've seen that I can pick you up off the floor, that's always been a hard floor. I'm not sure I could do it with you in a prone position and a squishy bed underneath my feet. I certainly wouldn't want to pay paramedics just to get you up after your nap."
    I had another concern that I didn't voice: I don't want my bedding soaked with urine that I'd have to try to get out, leaving me without my essential bed this evening. I could protect the feather bed with a plastic sheet (which steal some of it's fundamental comfort from my mother's napping experience) but we haven't the utilities to protect everything else.
    I probably should have felt miserly and selfish by refusing her, but I didn't. I did, however, suggest that we purchase a single feather bed for her mattress. I also reminded her that she sleeps with down comforters (which are much defeathered from constant washing but still serviceable) and a superior down pillow, so her bed comfort is fairly close to mine.
    She sighed. "I know," she said, "but you're bed looks like a nest."
    I laughed. "It is a nest, Mom, my ultimate nest. I got my love of sleep from you, remember. A bed nest is important to people like us. With an addition here and there, we can make yours into your ultimate nest, too."
    She laughed. "Bless you child," she said.

    One last curious episode today: Within the year or so (maybe a bit less) I've noticed that when I am gone from the room she's in (while she's awake) and sometimes when I'm out of eye-shot of her she begins to look for me. Thus, I try to cross her line of vision frequently if I'm moving around and if I'm not I make sure I am at least in her peripheral vision within the room she's in.
    Tonight, dinner preparations occupied me for almost 45 minutes in the kitchen while Mom watched television in the living room. I tried to pop in and out of the living room frequently but this didn't always work. When I finally slipped our dinner concoction into the oven and headed back into the living room, Mom met me on the steps heading into the kitchen to look for...well, that's the mystery.
    As soon as she saw me and registered my physical detail she said, "Where's G..."
    I think she stumbled over the "G" because, although it was a little late in coming, she figured out that I was who she was looking for.
    Later, though, while we were eating dinner side by side in the living room and discussing that we would probably finish "the book" tonight, she suddenly looked at me squarely and said, "When is..." she couldn't find the name but she gamely continued, "...oh, you know who I mean, when is she getting home?"
    On a hunch I said, "You mean Gail?"
    Everything about her told me she was going to say, "Yes", but then she paused, looked me in the eye and said, "No, you're Gail."
    "You mean MPS?"
    "No..."
    "MCS?"
    "No..."
    "MFS?"
    "That's not it, either..."
    "Dad?"
    At this she gave me that "Oh, come on!" look.
    "Well, Mom, I give up. You and The Little Girl and I are the only ones who live here."
    "I suppose you're right..."
    Which means, "I'm sure you're wrong..."
    We dropped it, but then I suddenly remembered a bit of conversation from earlier today when we were bathing her. I don't remember what we were talking about but at a certain point I jokingly said to her, "...and you're my mother."
    At which she replied, not jokingly but as though she was reciting a long remembered phrase, "...and you're my mother."
    I didn't catch it or question it at the time. Didn't even think about it. But, after the two almost-relationship-phasing incidents later today it occurred to me that, perhaps, most of the time now, I am her mother. Not her mother from long ago, but her mother now.
    Weird. And cool. I guess sometimes ultra-identification happens within Ancient Ones so smoothly that it goes unrecognized for long periods of time. It won't change anything between us, since my guess is my current identity is an established reality with her, now. It's just nice for me to know. It explains things.

    Early, early morning. Time for bed.
    Later.

"My mother exists in Timelessness, now...

2005-11-18T16:51:00.000-07:00

...and since I take care of her, so do I." Funny thing to say about a woman who always wears a watch and checks it several times a day. The desk clerk at the lab, when we went for Mom's blood draw today, noticed this and raised her eyebrows, questioning my explanation of why I was unsure of both the date and time of day (I don't wear a watch).
    "That's not a watch," I elaborated, grinning. "That's a Time Transport Bracelet. If she needs to exist in time, all she has to do is look at it and she's instantly back in Time."
    The lady laughed. "Well, if you ask me," she said, "living in Timelessness sounds pretty good."
    "It is," I agreed. "I'm not looking forward to having to come back to The Timed Universe when she dies."
    The lady patted my arm. "She looks good. I don't think you have to worry about that for awhile."
    Speaking of time, for my own reference, her blood was drawn at 1335 this afternoon. CBC only. I should be able to pick up the results Monday, although I may check tomorrow, since the lab has Saturday hours, to see if their up.
    Mom awoke on her own today at 1100. I think she was anticipating the blood draw. She was surprised that I suggested breakfast before the draw, but the CBC doesn't require that she fast. At the lab they didn't ask if she was fasting, for some peculiar reason. They usually do, whether a test requires it or not.
    Mom enjoyed getting out and looking around but complained about "the cold". I probably should have swathed her in her coat but I didn't think of it. The air felt warm to me until we got to the lab. I shuddered a little at her pronouncement that it was cold. If she's noticing "the cold", she's probably considering the possibility of beginning her winter hibernation.
    I'm heading over to enter stats.
    Later.

"If you spring from the bed, tomorrow, like Athena springing from the forehead of Zeus...

2005-11-17T22:55:00.000-07:00

...then we'll go have your blood drawn."
    We've been going back and forth all evening on whether to have her blood drawn tomorrow. The problem started when I mentioned that I'd be awakening her around 0930, no later than 1000, anyway, so we wouldn't be postponing breakfast until 1600 or so. Mom understood. And she wants to get it over with. But, considering her arising habits of late, well, I'll let her tell it:
    "Isn't 0930 still night time?!?"
    So, maybe we'll have blood drawn tomorrow and maybe we'll do it Monday. We'll see.
    She brought up the subject of her super-prodigious sleeping on her own this afternoon. "I think in a few more days I'll just about have my sleep out and be ready to go, again!"
    I was surprised that she brought it up. "Well, that's good to hear, Mom," I said, "especially since we've got plans in the Valley for Thanksgiving and it would be nice if you were up for being up."
    "Oh, that's right! We'll work on that."
    "Look, if you don't want to go down, it's next Thursday, you know."
    "Oh course I want to go down! I wouldn't miss it!"
    It's as though she read her body after a week and a half of flurried activity and "go, go, going" and realized it was time to take a break. At least this time I'm not freaking and trying to verbally whip her into moving. It usually doesn't work anyway and if it does we're both still miserable afterwards.
    Besides, I'm curious about her results. There won't be a BMP this time and I've been wondering about her sodium level, not because she's collapsing but because her fluid intake has been relatively low but she hasn't appeared to be dehydrated. I've been wondering if she actually is retaining fluid but is drinking so little that it doesn't look like it. Although I won't be receiving a sodium level on her, if anything in her CBC looks seriously out of whack I'll know that something else is going on.
    We've just about finished the book by Anne Rice about Jesus. If Mom's not sleeping or eating, she insists that we read. Well, except for this evening. I insisted that we watch a TV showing of the movie Julia tonight. I hadn't seen it since it came out in 1977. Mom was somewhat bored with it until the favor that Hellman did for Julia began. At the end she said, "They should have ended with the child being found."
    "Mom," I said, "the child was never found in real life. I'm sure they wanted the movie to remain true."
    "Oh, my," she said, "that really happened?"
    "Yes. Hellman wrote about it in her biography."
    "I should have paid closer attention."
    "If you want, Mom, we could check the book out and read it."
    She thought for a moment. "No," she finally announced, "I don't think so. That happened a lot back then. I know more than enough about that time."
    And, she does, having lived through it.
    Time to do evening stats.
    Later.

Today I found myself explaining the dignity of items to my mother.

2005-11-17T17:23:00.000-07:00

    I'd been talking with the oxygen supply company people outside when she awoke, so she tended to herself, went to the bathroom, refused to acknowledge that she was wet all over and walked into the kitchen in her besotted night shirt and underwear, seated herself on her normal chair and began reading her magazines and soaking the chair cushion with urine. When I returned and noticed that she was up and settled at the table I ushered her into the bathroom as usual for her bath and stripped the chair, put the soaked cushion in the wash and replaced it with a fresh cushion.
    As she was settling down for a nap and we had our usual bedtime conversation (we have one before every nap and every night sleep) I was standing in her room reorienting the foam inner section of the cushion to the loose outer cover while it was wet from the wash so that when it dried it would dry in the proper shape.
    My mother asked what I was doing and I explained the procedure to her.
    "Wouldn't it be easier," she asked, "to just rip the cover open, reset the foam then sew it back up?"
    As I continued to reorient the two pieces of the cushion to one another I thought about the tightly bias-tape bound seams, the integrity of the stitches. "Well," I responded, "with this particular cushion it would actually be harder because it's so well made. But, the thing is, Mom, every thing, and I mean every [pronouncing the word obviously separately] thing has it's own dignity. When you take it apart and put it back together you challenge that dignity. In a few cases, if some thing is made badly, you may improve the quality of the thing, then it becomes a better version of itself with an improved dignity. In most cases, though, unless you are deliberately repairing some thing, by taking it apart for your own convenience then putting it back together you compromise the thing's dignity. It becomes a lesser thing, with a less sturdy dignity."
    While I explained all this to my mother I was looking only at my working of the cushion. When I finished talking I looked at her in lieu of a final punctuation mark.
    She was regarding me with a look which rarely meets me coming from her eyes: As though I was just about the strangest type of child to whom anyone could ever have given birth.
    I joked with her, "Didn't you know, Mom, that when you gave birth to me you gave birth to an Uncommon Child of Wonder?"
    She smiled. Then laughed softly. "Oh, yes," she said, "and sometimes I still wonder..."
    At that I laughed heartily, bid her "Good Nap" and left her room.
    The lecture about dignity that I gave my mother, though, has stayed with me and prompted all my thinking since. I've been thinking about how peaceful our home is for both of us now that I'm letting her sleep as she wishes, be as active or inactive as she wants, taking her here and there when I need to but not forcing any miscellaneous trips on her, generally letting her call her own shots; allowing her the dignity of her own decisions about how to lead her own life.
    I think I've finally hit on the proper way to be with an Ancient One. I'm sorry it took me so long to figure this out but I'm glad I finally did.
    If my mother was depressed or obviously disturbed with her situation or herself in some way I would certainly change things, work on her to do this, do that, perhaps continue to force her to do things she wasn't sure she wanted to do under the guise that she doesn't really know what she wants or what's good for her, anymore. But my mother is happy. She's not at all depressed. She isn't disturbed about herself for any reason. She doesn't wish "things" were better or somehow different. And, finally, she knows what she wants. Her decisions can be trusted, for the most part, on her own behalf.
    Despite all we caregivers "do for" our charges, there comes a time when one is caring for An Ancient One when the best we can do is let our charge do what she wants, allow her the liberty not to do what she doesn't want, and simply hang out with her, surround her with love and protection and enjoy the moments we have with her. There is, I remind myself, nothing I can tell her about how to live as An Ancient One. I can only love the fact that she is living through Ancient years and not waste the opportunity to know her as Her Ancient Self.
    This is a very good way to live. I think it may also be a very good way to die.

I want desperately to stay up later than it is, now...

2005-11-17T01:40:00.000-07:00

...I want, in fact, to drink a cup of coffee and stay up all night. Not a good idea, though, considering that when I awaken sometime tomorrow it will be because I'll hear Mom shuffling into the bathroom upon arising and I'll have to jump out of bed, shift into high gear, my transmission will shriek, I'll leave tread and I'll be in a fucking hell of a mood all day long.
    I miss up-nights that usher in the dawn. It's at the top of my Miss List.
    Mom had a better day...awoke an hour earlier and although her knees were bothering her and she took a decent ibuprofen inspired nap, she lost the minor fluid congestion she'd been gathering, felt altogether better, lusted after the book we're reading so we read lots in it, ate well, felt good and stayed up until almost midnight. Warmth makes a difference.
    The very first winter we spent here in 1997, although we didn't get much snow, once fall began aging into winter we had day after day of highs in the teens and twenties. Although I can't remember what the summer and early fall was like that year, I'm shuddering at the thought that we're going to have another winter like that. I hope not. True, if there's sun our house is cheery and distinctly not winter-like, regardless of the temperature outside, but I can't even imagine what it might be like to try to coax Mom out when the temperature can't even be coaxed above freezing.
    All day long I've been mentally filing stuff I want to mention here. Finally I'm here and all I can think about is, "Shit, it's almost 0130...if I don't get to bed I won't have any time to myself in the morning to settle into the day before Mom awakens."
    So, you know, to bed, to bed, to buy a fat pig, or whatever...
    ...later.

The weather turned fall-cold today.

2005-11-15T18:33:00.000-07:00

    Since I've been keeping my bedroom window open I knew it when I awoke but thought it was me. I automatically opened the back Arcadia door so The Little Girl could spy with ears as well as eyes on our regular morning Gambel's Quail Convention and the breakfast scurrying of the ground and grey squirrels. Activity was surprisingly high out there so I didn't believe the whoosh of cold coming through the door. It'll warm up, I decided. I'll leave the door open. Even my after-shower shivering didn't convince me that our unusually warm weather of late was coming to an end.
    Finally, around 1000, when I noticed that the baseboard heaters in the living room were continuing to cycle on, I headed down the hall and shivered again. I immediately closed the back Arcadia door and my bedroom window, and, as well, the bathroom window. I sneaked into my mother's bedroom. She was mummy wrapped in her blanket, the first morning she's done that since mid-spring. That should have clued me into a possible late arising but I started gently rousing her every half hour at 1100 and finally stopped at 1300.
    The weather cast predicts a full 10 degrees warmer tomorrow, much less wind, still as dry as a bone. The next full week should see temperatures in the mid to upper 60's downtown, low to mid 60's here. But, it's coming; the cold is finally setting in. I know this because this morning the temperature of the cold tap water began leaning toward hurting cold.
    I can't say how much of a hibernation winter this will be for my mother. Even in this slow week and a half we've experienced since her active week and a half I've managed to have her do informal chair exercises with a few standing ones almost every day (without weights). She's been up and down a lot when she's awake, too. She just hasn't wanted to go out. We'll be going for a blood draw this Friday. That'll help me gauge how she's going to react to going out this winter.

Reading Begets Reading:
    Doing aloud reading with my mother the past couple of days has hiked my interest in reading silently, again. I'm picking the books carefully, mostly by size. Today I rebegan the book Sick to Death and Not Going to Take It Anymore!. Astounding little book about the poor state of healthcare for the elderly in this nation at the moment and specifics on how it can be improved. I highly recommend it to anyone who plans to get old and/or thinks they might at some point be caregiving for an Ancient One. I'll talk more about it later when I've finished it but I wanted to mention it, now, in case anyone finds the description apropos to their situation. If you've ever looked forward to old age with dread, this book is crammed with facts, figures and postulations that will cause you to either dread old age even more or activate toward a better old age for all of us. It is especially timely considering the soon to be instated Medicare Part D.

    I'm hoping for a somewhat more normal day tomorrow. Wish me luck.
    Later.

In celebration of the first sign-up day for Medicare Part D...

2005-11-15T11:23:00.001-07:00

...a few observations and a few questions.

Observations first:

Last night, as usual, Mom and I watched national and local news for 1.5 hours from 1730 to 1900. Mom is The News Girl. I'm not, but I accede to her wishes. Normally this is a time for me to do evening chores, fix or set up fixings for dinner and keep a peripheral watch on the news in case there's something Mom wants to discuss.
Last night's news watch included two national broadcasts: NBC and CBS, which play back to back on their local Arizona affiliates. The former broadcast featured a story set, yet again, at one of those infernal Medicare Part D "Help Sessions". The story included short interviews with a few seniors, one of whom (a woman) was completely confused, the other of whom (a man) was like a six year old who can't wait to hit the "hard books" in a "real school" and learn, learn, learn. After these snippets a man who was either a representative from Medicare or from one of the insurance companies involved in this suspiciously hoaxy program expressed his opinion that the Medicare Part D plan was difficult, yes, but so is filing a tax return; so is registering one's car [Really!?! I don't recall that registering a car is at all difficult. I'll concede the point on tax returns, though, which is why so many people who don't qualify to file EZ returns have H&R Block or a CPA do it.], etc. Yes, he said, "some" seniors are going to need help, but help is available in a variety of areas for seniors, anyway; helping seniors is not new. And, he added, this is good for seniors. They have to "go back to school", insinuating that it's been proven beneficial for seniors to stimulate their minds.
Curiously, as I recall (and I may be wrong about this), CBS did not broadcast a story about Medicare Part D.
Flashback to the November 6, 2005, airing of the "live debate" episode of The West Wing in which the democratic candidate for President mentioned that administrative expenses for Medicare are substantially lower than those for commercial insurance. He cited the figure of "2%". It seems that the Congressional Budget Office cites an even lower number: 1.2%.
Our illustrious government assures us citizens that the reason for commercial insurance company involvement in Medicare Part D is to control costs (by this I have to assume they mean administrative costs, since insurance companies are going to be on the side of commercial drug companies when it comes to protecting drug profits), to allow the plan to be tailored to the individual in regards to types and costs of product (which Medicare is already doing, by the way) and insure the ever elusive and malignant American Ideal of Choice for the Consumer.

Here are my questions:

Why should anyone have to "go back to school" to receive adequate, cost effective health care for themselves and their charges?
If it is common knowledge that Medicare operates administratively much better than commercial insurance companies, why is the government "trusting" commercial insurance companies to administer Medicare Part D?
Could it be that the current government is not interested in cost-effectiveness but rather in lining the pockets of powerful commercial lobbies?
How much money is Medicare spending to explain an exceedingly difficult program which, ultimately, will need to be explained over and over again? Is this part of President Bush's Jobs Creation Plan for his second term? If it is, shouldn't these jobs be stimulated in the private sector and backed with laws and private agreements insuring livable wages and, yes, health care insurance?
Is this program the beginning of an insinuative insurance that the pristine development of professional Medical Advocates will be imperceptibly overtaken by commercial medical-industrial interests and ultimately not operate on behalf of the patient but on behalf of the medical-industrial complex?
If "help" for seniors is so readily available from family and outside sources, why do country-wide seminars have to be set up to teach seniors where to get help?
We all know that no one, I repeat, no one relishes the possibility of declining mentality as one ages. If keeping mentally fit were as easy as going to a Medicare seminar, don't you suppose there would be a lot more seminars and a lot fewer seniors whose "intellectual acuity" (Thank you MFASRF) was in decline? Wouldn't you figure, in fact, that seminars would not be needed, that staying mentally fit would be as easy, as natural and as freely available as expanding intellectual ability in one's growing years?
Why does President Bush and his administration, why, in fact, do most of our incumbent and prospective political leaders, as well, continue to institute and promote policies and programs which are clearly pro-business and anti-common-citizen?

Just wondering. The last question, by the way, is rhetorical.
Later.

"I go now to report your latest bowel movement to the world."

2005-11-14T16:39:00.000-07:00

    "What!?!" She always forgets exactly what I put into these journals about her and me.
    "I keep track of your bowel movements on the web site, so your boweling schedule is available to the entire world."
    "Well, I can't imagine that very many people check up on that!"
    "You're right. Not many do. But that section gets about 50 visitors a week on average. So, someone out there must be interested!"
    With that she delivered a comic sneer and settled into her nap.
    Today is one of those days when I feel as though all the gods are walking with us, ahead and behind, smoothing our way, allowing us to feel safe, comfortable and in sync with life. Although it hasn't been a very active day, chores for me, reading silently for Mom, reading aloud for both of us, chatting about this and that, it has the air of the peaks about it. These are the days I live for.
    Mom asked me today, while we were putting on her bra, if I remembered how excited I was to wear my first bra.
    "Yeah, I do, Mom, do you?"
    I meant her excitement about her first bra but she mistook me. "I sure do. You bugged me about getting one for months before it was necessary. When we finally got you one, after you'd worn it once you didn't want to wear it anymore. You didn't like it. A couple of months later you didn't have a choice." That was a few years before women took off their bras.
    I was surprised she remembered this about me. She's exactly right. I meant to ask her, again, about her own experience and whether she remembered the rest of her daughters' experiences with their first bras but we got to talking about something else and the moment passed.
    Looks like this facility will be down between 2200-0000 tonight my time. Better get over to the movie site and do some of the entry I was planning on doing tonight after Mom retires.
    Later.

You'll notice...

2005-11-13T23:18:00.003-07:00

...under the Special Posts section at the main journal an addition, a link to Mom's Current Medication & Supplement Schedule. This link will be refreshed as significant changes occur to her medication and supplement schedule and will always take you to the most current schedule. Minor daily changes will continue to be covered in the daily posts at Mom's Daily Tests & Meds. I will not post a new schedule and refresh the link to the right unless a significant change takes place. For instance, I'm considering boosting her lisinopril dosage by 100% yet again, but I'm going to take a week or so of observation with her on 5 mg/twice per day to see if I may be jumping the gun. If I decide to take her up to 10 mg/twice per day I will redo the schedule, post it and refresh the link to the right.
    I noticed in today's New York Times Online that the lead story is about the mass confusion generated among those eligible for Medicare Part D. Although the article mentions that "only 35%" understand the plan and those that say they understand it are more likely to consider it "beneficial", from what I understand of the plan I'm thinking that those 35% probably understand the plan, which, actually, is fairly easy to understand, but still have problems with the idea of sorting through about "three dozen" possible institutions of the plan in order to determine which would be most beneficial for them. As well, the "extra help" section poses yet more problems and Social Security comes into play in that area, which can always be counted on to 1) create even more confusion, and 2) summarily deny coverage unless a citizen fights for it. The bottom line is, it isn't the plan that's confusing so much as the options. I consider myself extremely lucky that my mother's retired/veteraned military status makes it possible for me to ignore Medicare Part D for her or I surely would have been one of the millions of folks who are lining up for the Medicare Part D seminars everyone and their dog is offering and allowing myself to be even more confused.
    As well, although I have yet to receive my email edition of tomorrow's (November 14th's) NYT Online, I took a sneak peak and noticed the headline story is as follows: Big Drug Makers See Sales Decline With Their Image. The blurb for the story reads thus: "The major drug makers remain highly profitable, but at some, sales are stagnant and profits are falling, leading to layoffs and cuts in research budgets."
    Isn't it interesting that just as drug companies are beginning to sweat, along comes the federal government with Medicare Part D which should allow drug companies to recoup some of those losses by simple dint of consumers' confusion and inability to pick the plan most financially favorable to them.
    And we've got Bush and his (luckily declining) ilk for another three years! To all those who voted for Bush and his cronies, what the fuck were you thinking?!?!

    Although Mom's activity quotient has been low lately, we've had several very satisfying days. Today was yet another. I could not convince her to go to Costco with me, which was okay. While there, though, perusing the books, which I only occasionally buy anymore since I rarely have the time to read or the isolation I need to concentrate when I read, I noticed a book about which I'd recently read a review, written by one of my favorite "please, seduce me" authors, Anne Rice, Christ the Lord: Out of Egypt. When I read the review I had a hunch Mom would love us reading this book aloud. I purchased it today and discovered I was right. She was immediately transported. I read aloud to her, checking at the beginning of each chapter to see if she wanted me to continue, for two and a half hours until my voice began to break and she began to hunger for dinner. I have to say, it's a fun and easy book to read aloud. It's much leaner than most of Rice's books. As well, it appears to be extremely well researched (which is typical of Rice's books) and uses a variety of sources. After we covered chapters 1-5 Mom asked if there was any information on her sources. I leafed through the book and discovered the rather long Author's Note at the end which explains, somewhat more lavishly than the text of the story (and more in line with her previous lushly written novels) her entire journey to and through creating this book. Interesting. While I was preparing dinner Mom scavenged the book and wondered aloud whether the author might be writing any more about Jesus. The review I linked to the title of the book seems to indicate that this is the beginning of a series.
    "Good reason to start reading in the evening, again," Mom said.
    I agree. Although, as you know, Mom's memory can be highly creative, interestingly, she stopped my reading aloud several times to reflect on what she knew of Joshua-bar-Joseph's life and times and what the book mentioned.
    I also picked up another book by chance that I know is going to be a Read Aloud Hit: Doris Kearns Goodwin's Team of Rivals. Some years ago we read No Ordinary Time aloud and she (and I) so thoroughly enjoyed that book that, although she doesn't remember the title, she continues to think of it on occasion and refers to it as "that book about Roosevelt". I'm glad that Christ the Lord: Out of Egypt is as short as it is, as we are both lathering to begin Team of Rivals. Which reminds me, speaking of tomes that Mom might enjoy, in the mid-90's I discovered and read what was then an "old" book by Robert Hughes, The Fatal Shore, a meticulous, no holds barred, daunting history of how white Australia came into existence. It was a page turner from beginning to end. Maybe we'll take that one on after Doris Kearns Goodwin's Team of Rivals.
    There are still many, many books I'd love to read silently on my own but reading aloud, especially tantalizing books in which both Mom and I have an interest, takes the edge off my missing of my own reading and allows me to incorporate some of it into my caregiving life. I'm glad we're doing this again.
    Just a couple of notes about the last few days: Friday and Saturday we watched a couple of movies that thrilled Mom, De-Lovely and The Last Emperor. The first we watched on Friday and Mom sang along to it. The second we watched in two parts, Friday evening and Saturday afternoon. It's one of my favorite "overwhelm me" movies. I know Mom has seen it before because I've rented it many times but she didn't remember any of her previous viewings. The copy we watched this time, though, is ours. I "sold back" some of our movies to get these two. I noticed during this viewing that Mom and I have only occasionally similar reasons for enjoying it. She pays little attention to the political implications and developments in the movie but loves the cultural detail. I remember, many years ago when we lived on Guam, Mom had a collection of Chinese music that she would occasionally play on our phonograph. It was not uncommon for her to play it while doing chores or fooling around with possible school projects at the kitchen table with us kids. Although I enjoyed the music, too, I remember wondering every time she played it about the extent of her fascination with Chinese culture; wondering, as well, if her interest had the same "destined" quality as her interest in Egyptology and Sioux-ology. I haven't yet thought to ask her outright but our recent viewing of this movie reminded me of my curiosity, especially since she noticed that there were differences between what she is used to seeing depicted as Chinese culture, especially in dress, and the distinctly Manchurian detail of much of the movie. MENTAL NOTE: Ask her. I will, of course, record her response here, once I remember to ask her.
    Later.

And here's another thing...

2005-11-12T11:01:00.000-07:00

...has anyone noticed that this Medicare Part D plan, with it's built in confusion and ability to be accidentally misunderstood and misused, is being foisted up one of our two most vulnerable populations, those two being our children and our elderly? Of those two populations Medicare Part D falls upon the vulnerable population that is the least well cared for?
    It's almost like it was planned this way.
    Once again, thank you President Bush.
    ...later.

No, nothing's been wrong...

2005-11-12T01:49:00.001-07:00

...in fact it's been a very satisfying week. I just haven't gotten back to the computer, much. I've been doing other things. I discovered, tonight, that I need to at least keep up on stats, though. As I was going back and reviewing them for stat ketchup over at Mom's Dailies I noticed that the Blood Glucose monitor had lost a day's date apparently a few days ago and all her blood glucose stats were mis-dated and mis-timed. That was fun. If I'd been keeping up with entering them I'd have noticed it sooner. Luckily, I was able to remember when I did and didn't take glucose readings and time them accurately from comparisons with her blood pressure readings.
    After a bit over a week of active days, Monday this week began a week of Mom not wanting to move much. I gave in. She stayed up quite a bit, actually, and there were a few days when she didn't nap. She really slept in this morning, our first rainy, stormy day in a long time. She awoke once about 0930, went to the bathroom, had not yet leaked through her underwear, we changed them, she went back to bed for another three hours and when she awoke her bed and her pajamas were still dry, so it was a light chore day for me. I hadn't realized, previously, that half my chores center around her leakage. As well, of course, we only had to bathe her groin. I checked her over, as I usually do, and we applied lotion and she washed her face but there wasn't any reason to do The Full Bath Deal.
    When she's been up we've been catching up on movie watching, talking, looking through holiday magazines for interesting recipes, drawing up lists of ingredients and comparing them against what we have, read-watching more of the Bible DVD, playing Sorry and talking. There was one time phasing episode wherein she thought I'd roomed with her in college and wanted to know what I'd heard from "Mavis" and some of the others in her college clique. Otherwise, though, she's been pretty clear and in the moment.
    When she hasn't been up I've been combing stores for more unusual ingredients. I'm still trying to locate Robertson's Scotch Marmalade locally; I used to be able to get it from our regular grocery but apparently they no longer carry it. I've also been sorting through our food cupboards, getting rid of stuff that's too old to use.
    I've also been attending to paper work sorting and spending some time determining whether my mother should sign up for the new Medicare Part D. As it turns out, she needn't bother. She's getting a much better deal from TriCare than she could possibly get from Medicare, especially since she takes so few prescription drugs. Thank goodness!
    After reading all kinds of booklets and website about the Plan D I'm realizing that it is probably yet another way our government is making it so difficult and confusing for us citizens to get any prescription drug help that many of us will either manage to be confused right into spending more on prescription drugs than we already are or need to or give up and decide to go it as we've been going. Such a shame, and a sham. WHY CAN'T THIS COUNTRY FIGURE IT OUT?!? HEALTH CARE OF ALL TYPES SHOULD NOT BE LEFT TO BIG BUSINESS OR A GOVERNMENT THAT CAN'T AND/OR DOESN'T WANT TO CONTROL BIG BUSINESS!!!!! Jesus fucking Christ!
    So, anyway, life is continuing smoothly, I'm feeling good, Mom's feeling good, we're both doing well and looking forward to the holidays.
    Oh, I had one low day. I ran into our Fed-Ex delivery woman at the grocery last Friday. I wished her "happy vacation in November" from her parents and she effervesced into telling me that yet another rung of her family, an extension in Phoenix (so weird that she has extended family in both Florida and Phoenix and so do I) have decided to host her Mom and Dad for December in order to give her and her husband a holiday break.
    "It's the best Christmas gift we've ever gotten," she said.
    I can imagine. In fact, I spent the rest of the day imagining what it would be like to have family members come out of the woodwork and offer to host their shared elderly relative(s) for a month here and a month there. Then I got over it. You know, whatever. The truth is, if passing shared relatives around doesn't start fairly early in the shared relatives' Ancient dependency, pretty soon it becomes impossible because of all the necessary routines that need to be carried out and which take a little time to understand and get used to.
    I know a change in our the WASP social structure isn't going to happen while I'm sharing my mother's life. I hope, though, finally, this documentation will become an avenue to a grand rethinking of social structures within the U.S. (and elsewhere, if necessary) that, well, that will make it impossible for what is happening to me, to me my mother and lots of other people to happen.
    It's getting late.
    Things are fine. I'm not sure how much I'll be reporting here for awhile. I've still got lots of stuff I want to attack and I can't help but take advantage of this easy, delightful period of enjoying Mom.
    She thinks she might want to go to Costco with me tomorrow. Hallelujah!
    Later.

"No such thing as extended release..."

2005-11-04T23:57:00.000-07:00

    This is the third time I've had "extended release" problems with medication prescriptions; the second time the problem involved being told by a doctor Mom would be getting an "extended release" version of a medication that doesn't exist. Each of the three episodes has involved a different doctor.
    This time Mom's doctor told me he would be prescribing an "extended release" 10 mg tablet of lisinopril for Mom to take once a day. When I called the pharmacy to ask some questions about the prescription and referred to it as "the extended release version" the pharmacist flatly told me that there is no such thing, yet, for lisinopril.
    "Really. Interesting. That's the second time in a couple of years I've had a pharmacist tell me that information I got from a doctor about a medication was wrong."
    Short silence. "Well, I don't know what to say. All I can tell you is that lisinopril does not come in an extended release form, generic or by brand."
    See, the thing is, I think doctors know, for instance when a particular medication is not available in an extended release form. I think doctors are still in the habit of lying to their patients and patient advocates in order to promote a type of placebo/self-hypnotic effect in a particular direction within the patient. The problem is, now that people are doing more medical research on their own behalf and much more information is being made available for laypeople to do this, doctors are now going to have to deal with the effect of patients' reactions to medications and procedures when the patient knows the doctor has been lying to them.
    Guys, it's time to come out of your god-closets and step up to the medical plate. Your patients and their advocates are waiting for you...
    ...later.

Mom's doctor thanked me heartily, Tuesday...

2005-11-04T15:27:00.000-07:00

...just before he left the examining room, for taking such "good, close care" of my mother! I've been meaning to mention this over the last few days as I remember it at odd moments.
    My reaction? I was flabbergasted. I said, "You're welcome," of course, and mumbled something else about how it was nothing, it is my mother, after all.
    Wow. I cannot express how good it feels to have her doctor, her PCP, too, thank me. Most doctors would prefer that I not be anywhere near my Mom when they're seeing her so they can have at her and make their decisions in the absence of her mind and anyone else's but theirs.
    I just picked up the 10 mg/1 per day prescription for lisinopril. Over the last few days I've been giving her 10 mg as two 5 mg doses twice a day to prepare her body. I think, at first, I'll try administering the dose at night, either at dinner or bedtime, that I haven't decided.
    It's a mellow day, today, which is fine with me. I don't know why but I woke up a little irritated and decided I needed a down day. Mom's sleeping off something, I'm not sure what. It isn't me. I was pretty good at putting off my irritation when I was around her.

Wow!

2005-11-03T10:17:00.000-07:00

I think I covered everything!
Later.

Time for me to start filling in about Travel Day.

2005-11-03T10:13:00.001-07:00

Mom's Blood Pressure:

    First of all, I've completed the project to which I referred earlier: An averaging of her blood pressures per month and per period for as long as I've been taking them. I've posted the results here at Mom's Daily Tests & Meds.
    I got the idea from something her PCP said when we discussed her blood pressure and I talked about how I'd been upping her dose of lisinopril based on the BP's I'd been taking two to four times a day. He was overwhelmed with the numbers. We both acknowledged that she appears to need a bit more lisinopril to keep her blood pressure in order.
    At this point I asked if my concern for her BP was "out of hand".
    "Yes it is," he said, "and let me tell you why." It seems that the value of BP readings are most valuable when taken on an average. "Don't compare apples and oranges; look at all breakfast readings, all lunch readings over a period of time."
    So, I decided to average her BPs over all the months for which I have at least three readings for each meal per day, per month. You can definitely see the tighter control with lisinopril obvious in the steadily declining averages.
    The PCP also told me that doubling the dose of lisinopril usually accounts for only a few points of a drop per indicator. Thus, he wrote Mom an Rx for 10 mg lisinopril/day once a day. "If, on a particular day, you think she needs it, you can also administer another 10 mg at dinner." He also explained that most of his patients who are being treated for fairly high BP are on 10 mg/twice per day, so Mom is well within not-overmedicated range. He is happy with her averages across the board, though.
    I asked him about how often I should check her BP.
    He surprised me: "No more than a couple of times a week. Then take them for all periods and wait a couple of days, unless you see something unusual over that day."
    I'll try, hard, to do this.
    I need to get that prescription filled today. Yesterday I made sure she got 10 mg lisinopril in all (two 2.5 mg tablets in the morning, two at night, since they are not extended release).

Shots:

    Yeah, I was blown away that the pharmacy up here has flu, pneumonia and tetanus shots and her doctor's office did not. She won't be able to get a pneumonia shot at the pharmacy. Under Medicare they only give the pneumonia shot every six years. So, Mom can get that one in April at her doctor's office in 2006.
    Hmmm. I just called the pharmacy about shots. It seems that the shortage that affected my mother's PCP's office is not affecting the pharmacy. Although there were times in the last week when the shot table was free for long periods of time and there was not a run on flu shots it seems that "the shortage" (this is the first I'd heard of it) is dictating that the pharmacy does not have its inoculation tables up this week and is hoping to do one more run 11/5 from noon to 1800. But call, she cautioned.
    As for the Rx for lisinopril so soon after the last one, she explained that since Mom is on TriCare the Rx may override the last as a new Rx, in which case I'll have extra if she needs more than 10 mg on a particular day, and I can experiment with anywhere from 2.5 - 10 mg if this should happen. I'm always looking for a way to use the least amount of medicine possible.

Ears:

    The nurse did indeed perform "ear lavage" on my mother's right ear (the problem ear), four times in a row until Mom acknowledged that, yes, her ear was developing some tenderness.
    The nurse also invited me to peer into Mom's ears. She used the left as the control ear, since it was clear. I could clearly see the plug of wax in her right. It was much tinier than I expected.
    "It doesn't take much to block one's hearing," was the nurse's response to my amazement.
    Although full removal was unsuccessful at the office the plug was apparently loosened enough so that her hearing was restored yesterday morning and remained so all day. I'm assuming the plug drained out.
    The nurse suggested that if it didn't drain out we could come back in "a couple of weeks". I explained to her that I'll use Debrox again before we take another trip down and up the mountain so soon.

Let me check my previous lists to see if there's anything else I can fill in off the top of my head.

Bowels on the Run:

Is explained in the only post for November 1, 2005, at Mom's Daily Tests & Meds.

Dem Old Bones

Mom is simply no longer comfortable in a car if she has to fold and unfold herself as she enters and exits. No more low to the ground cars. Even with the aid of my "hootchie kootch" stretch that I do immediately after getting out of a car and through a modified version of which I direct my mother once she's straightened out up exiting a car. Of our cars, the truck is more comfortable than the sedan except that the design of the seat, itself, is uncomfortable for her: It throws her back and makes is hard for her to sit on her but rather than her spine. It's weird.
So, I don't know, I think about this every year or so, maybe we'll look into purchasing a "new" (new little used cars are a possibility, too, especially if the warranty travels) car, trading in our two cars on one. We'll see

The Air Up Here vs The Air Down There

The city smell was much stronger on this trip, even though the air was tinged with blue. Mom didn't notice it but she used more oxygen than I was expecting. Through most of the appointment she was on oxygen and didn't mind it. I noticed her mouth breathing more than last time. Although during lunch, right after we hit The Valley, she did fine while sitting without oxygen. She could have used it every time she moved, though, but the walker was a tight fit for the bathroom. She used it on the way in and out, though, although not on continuous. She breathed fairly well through her nose on pulse, which sometimes doesn't happen up here.

Cigarettes and MCF's

As it turned out she only had about 6. She, of course, didn't smoke while she napped, no one made a big deal of it and cigarettes were cleared from the table several times during the evening for appetizers, the meal, the giving of gifts, dessert. You know how it is when it's your birthday.
I slapped continuous flow 2/lpm oxygen on her for the trip up after the cigarettes. She was an animated companion. She did want a cigarette when we'd finally settled at home and the door was no longer due to be open for unloading. I lied and said she only had one left in the pack and she could have that. I figured it would relax and daze her enough to get her to bed, which it did, around midnight I think.

Manicure Kit

No one carries the type of manicure kit I have in mind anymore. So, I'm going to look for it on the web. We did, however, replace her collection of manicure tools that have broken or rusted beyond repair.

"Family" Discussion

I am glad and we are lucky that Mom and I are so comfortable with MCF&Family that we plan like family. MCF's family owns a cabin in the southwestern mountains around Pagosa Springs, Colorado. Cabin Elevation: Around 9200'. Anyway, she had her photos from a recent visit and passed them around the table. The place reminded Mom a lot of Spearfish Canyon, SD; more than reminded her. When it was suggested that maybe Mom could tolerate that altitude for a few days, I noticed her gently phasing into Spearfish Canyon, at a somewhat lower elevation, and announcing that of course she could, she'd been "there" many times. Anyway, both MCF and I think that in a warm season, late spring, summer, if she's up to it in a little less than a year (you never know), we might be able to do this. Mom became very excited, phasing all over the place, wondering if we "might run into any of the folks" while we're "there".

Miscellaneous Stuff:

Mom's excitement about Christmas was more than evident. She volunteered some of our plans without confusion. On the trip back she suggested that we plan "a shopping trip to the Valley". I'm in favor of this, even though it will mean another down-and-up day. I'm thinking maybe I can plan one on one of MCF's off days in the middle of the week, we'll throw in the wheelchair this time for Mom's and our convenience and hit the Chandler Mall and maybe a few other places.
Once during the trip while we were in Ulta she demanded, "Where's my purse?!?". She's ready to shop.

    Yesterday was a lost day, a recovery day. Today might be, too, since we don't have to go for shots today; can't, in fact, until Saturday, now. She may or may not want to go to Barnes & Noble with me. I have a birthday gift certificate for that store burning a whole in my pocket. As well, I have several small home improvement projects planned for the house and have my information from MCBIL about which electric drill and bit set to buy. Maybe I'll do that today, too, if it looks like it's going to be a slow, sleepy day for Mom.
    My primary plan is to deliver nutritious meals to her today, cut waaaay back on the sugar and monitor her hydration.
    My secondary plan is to drink lots of coffee.
    Oh. If you click on the link above regarding Spearfish Canyon and scroll down the page about two third of the way, you'll see two paragraphs headed, respectively: Savoy and Roughlock Falls. In the one about Savory you will read mention of Latchstring Inn, which my maternal grandparents owned and ran for a couple of decades. Roughlock Falls is "about a mile up" from Latchstring Inn. We would frequently hike "up there" and spend a few hours during the day in the summer when we visited. The canyon, by the way, is enchanting in the winter. Used to be hard to get into and out of but my understanding is that the roads have been rebuilt and that problem is fairly well solved. Apparently there are places in the Canyon, now, where one can jet ski. Makes me shudder.
    Later.

Nah...

2005-11-02T07:17:00.000-07:00

    ...I'll stat later. With two Starbucks gift cards under my belt I've got enough time before the rental place opens to gas and get an eggnog latte. I'm a day behind.
    Oh, and the dogs. I want to mention about the dogs.
    Later.

Let's see...Other things to mention about our trip yesterday as I get the chance:

2005-11-02T07:11:00.000-07:00

Mom smoking at MCFs
The "family" discussion of MCF's family's cabin in Colorado and a discussion about the possibility of both Mom and me visiting next year (you never know)
Thanksgiving plans refined
flu and pneumonia shots
old bones
The Air Up Here vs The Air Down There
stats for yesterday
explanation of project
the disposition of Mom's ears

    In the meantime, I have a car to gas and deliver.
    Later.
    Hmmm...maybe I'll do stats now, get that out of the way, and return...
    ...later.

"We had an excellent day today!" Those were my last words to Mom tonight...

2005-11-01T23:59:00.001-07:00

...as she retired.
    Her last words to me, delivered with her head tilted in her characteristic "I'm overjoyed" pose, were, "We certainly did! I thoroughly enjoyed it!"
    After days like today and images like the last she offered me before sleep crept between us, I have to say, it's hard to believe that one day this woman will be dead. I see why she has such a hard time believing in her mortality. I have a hard time believing in it!
    She so exuded vitality that her doctor did a double take when he entered the office, made to greet her first, as he always does, for which I am eternally grateful, it is she, after all, who is the patient, and spied her sitting on the edge of the examining table, swinging her short legs so they knocked against the side of her perch, channeling an 11 year old boy about to slip away from the adults and manifest the mischief on his mind. He was charmed like a bird off a tree. I'll bet he questioned her mortality, too, asking himself, "Is she even human? She's probably one of those immortal creatures in Cocoon who have never died!" Although in the movie one does die.
    I noticed today that her PCP is just coming into the lap in which he will hit his stride as a physician and a healer. He's much more comfortable with his patients, any tag-along advocates and himself with his patients. He has a very quirky, ingenuous, likable character, aside from his A.I. brain. I noticed he is running a "family practice", as well. I'm actually pleased about this. He is good enough and interested enough in doctoring that he might be one of those physicians who follows patients from various states of adulthood into Ancienthood.
    The upshot of our appointment is that he doesn't think it's necessary to see her for another five months. Perhaps she's hit an octagenarian plateau that we haven't known about because so few "normal" people have ever before antcipated one's late 80s or lived through them.
    I've designed a project as a result of one aspect of the appointment: her Blood Pressure. I'll be performing it shortly to inform myself about her blood pressure profile. I'll explain later.
    In fact I'll be further elaborating and explaining lots about yesterday later.
    Oh. Mustn't forget "Bowel's on the Run"; not in the usual sense.
    When I mentioned to her PCP that she seems to be hitting the blossoming I'd been expecting at the advent of summer he responded, "We'll take it any time we can get it."
    I am so curious, now, to find out how she will eventually die. I can't even imagine, anymore.
    No Rx for an oximeter. We forgot to discuss it. But, I'm not worried. She ran for about half the day without oxygen.
    I need to start the next round of drying and hit the sack. I have a car to fill and return in the morning. I'm not even going to edit this post for anything.
    More...
    ...later.

Oh, yes. And the following:

2005-10-31T15:57:00.000-07:00

We are keeping the cane.
Mom will, indeed, have her ears cleaning professionally tomorrow unless they drain completely between now and 1400 tomorrow.
I haven't forgotten about my intention to write about things caregiver's aren't supposed to say to their visitors. I just haven't had the time, although the list continues to expand in my head. Expect that sometime within the next week or so.
I have yet to get back to finishing the cataloguing for the index. Let's hope some time opens up for that, as well.

Again, later. Really.

Although I worked hard yesterday to prepare...

2005-10-31T15:56:00.000-07:00

...everything ahead of time for today so that I could have most of a day to myself, somehow I managed to space the fact that tomorrow is a travel day and there's lots to do to prepare for that, including:

Doing The Full Meal Deal on Mom's hair;
Coaxing her body into moving its bowels (which hasn't yet happened);
Setting aside all our traveling supplies so they can be easily and quickly stowed in the car we're renting;
Choosing Mom's outfits (a couple of changes, just in case) ahead of time, packing the alternates, laying out the initial set;
Making sure all bills due at the beginning of November are paid so I'm not worrying about that;
Compiling a short "study" of my week long experiment on Mom with lisinopril to present to the doctor for discussion about whether to up her dosage permanently;
Seeing to it that her blood sugar record is up to date as of today (her PCP always asks);
Making eggnog bread, a loaf of which I'll be presenting to MCF and her family because she, knowing how much I love eggnog, is the one who told me about eggnog quick breads;
Compile and a list of things to do gather and do tomorrow for the trip.

    In addition, Mom's excitement about the trip tomorrow continues. She is not, I should mention, at all excited about the doctor's appointment. She's asked me once today if, since it's "merely routine" we could cancel it and spend the entire day at MCF's. I didn't think she was going to go down for a nap but spending an hour under the hair dryer relaxed her into a nap mood so I can take some deep breaths, now.
    As well, although the birthday meal I planned is in the Preparation-Lite category, still it requires some preparation. And, of course, there are all the daily chores to do as their optimum times approach.
    I'm in a good mood, though, and feel like The Proper Birthday Girl so the day is advancing well.
    I probably won't post again until Wednesday except for the rest of today's stats. So, here I go an my birthday way...
    Later.

Once again, Kidneygurl, my gratitude to you in spades...

2005-10-31T10:53:00.001-07:00

...for the url to the excellent template prescription letter for an oxymeter/oximeter. I've already created a filled in copy of it, printed it and have it ready for our doctor's appointment tomorrow. Being conservative as he is it's possible that he will not think it is "time" for me to have such a device, but I noticed on the Nonin site that I can buy the same handy-dandy instrument off prescription as either a pilot's or a hiker's aid. When I searched out costs I discovered that a Nonin discontinued pilot's aid, which has been replaced by a newer model, is selling for $100 less than the portable medical model which appears to be exactly the same type. I'm going to try for an Rx first, in case Medicare/Tricare will subsidize some, if not all, the cost. If that doesn't work we'll purchase the discontinued pilot's aid outright.
    As an aside, for those of you who are interested, the template is a very succinct, complete document which, with only slight modifications, can handily be used as an Rx letter for any of a number of medical assistance devices. As well, it is part of a site, EFFORTS (Emphysema Foundation For Our Right to Survive which looks as though it is extremely complete and thus very helpful for those with pulmonary problems. It's a keeper.
    Mom decided not to accompany me on my two errand trips, yesterday, but that's all right. I'm encouraging her to rest up for Tuesday. Her usual physical profile is that, after several days of movement a couple of days of rest acts on her like a weightlifter doing a couple of days of strenuous workouts. My guess is that tomorrow, in The Valley, she will be in tip-top shape. As well, the lower altitude will enhance her ability to breathe and her energy level. She'll probably be unstoppable. She's remembering the trip, very much looking forward to it and has even remembered that at MCS's home, where we'll be spending the afternoon and evening, there is a toy dachsund with whom she's fallen in love. She can't wait to see him again. I expect that the visit to MCS's home will involve some cigarette smoking so somewhere along the way I'll pick up a pack of cigarettes for her so she doesn't smoke MCS out of hers.
    I hear her blowing her nose. Time to start her day.
    Later.

Ach! There is much I want to report...

2005-10-29T23:55:00.001-07:00

...but I'm close to dead tired so I'll do some skimming as a reminder to myself.

I can't believe into how much movement I've been able to coax Mom in the last, oh, over a week now, I think! It's exhilarating (for me, anyway). Today, after braving a couple of her "no"'s, I got her to Costco. She performed admirably, sampled her way through the store (as usual), insisted that we do more aisles than we needed to do then I treated her to some advanced people watching while we split a Berry Smoothie at the luncheonette after paying for our goods. This is the fourth day in a row I've been able to get her out.
Tomorrow we may or may not get out. In the morning I'll be making a list of some advance experimental holiday baking and checking to see if we need any ingredients. As well, I've decided I want to make some pumpkin cranberry muffins for my birthday (maybe on my birthday). I need to purchase some pumpkin for that. We also need to pick up some more paper underwear for her, so, yeah, I guess we probably will be getting out.
The Getting Out Day that surprised me the most was yesterday, because it was gray and misty with a touch of rain. She was indomitable, though.
Although I've noticed the following in my peripheral vision before, today I was consciously aware that my mother attracts an unusual amount of attention when she's out and about. I thought about it today and realized there are a couple of reasons. First, she and I are relatively noisy in public, talking and discussing as we go. I think this surprises people. Others notice us chatting and slying our way through the public arena chiefly because we are both so animated and neither of us has particularly quiet voices. Second and most important, though, is her intensity. It's funny, I always thought I inherited my intensity solely from my father but now I see that my mother also possesses a remarkable intensity. Her eyes dart about as she studies everything and everyone surrounding her. She, like me, has a habit of inviting herself into conversations that started without her, including with strangers. She has an air of determination and interest in others that fairly shimmers in the air around her and makes her hard to miss.
As you'll notice, Kidneygurl again comments about a spa day, perhaps half a day, she suggests. I mentioned this idea to my mother this morning. She remembered that she and her sister indulged in a couple of spa days before I came to live with her and one in my first year with her when I was working and she and I were leading fairly separate lives out of the same house. She was more than game for the idea. She enthusiastically suggested that we invite her sister along, as these were some of their most fondly remembered times together. "We can certainly afford to treat her," she said.
    "Well, you're right, we can, Mom. But, you know, [MS] will be able to get in free, now that she's dead. She won't be able to be there in body, which is a shame because that's what spa days are all about, but I'm sure she'll be there in spirit."
    I watched my mother's eyes dilate while she refocused her memories of her sister back into the present. "Oh. That's right. I suppose you're right. I'm sure she'll be there in spirit. Too bad she won't be able to enjoy the pampering, though."
    I agree. But, you know, maybe there's some sort of spiritual spa at which she can make a parallel appointment at the same time as ours and experience the delight of being pampered at the same time as us.
Kidneygurl also mentions the Nonin company as a source of oxymeters. Thank you, Kidneygurl, for reminding me of this. I chanced on them over a year ago when I was looking around for an oxymeter and I remember being impressed by the price, which was significantly lower than several other companies. I need to do some fast research on this, in case it would help to have a prescription for one. We're now in a position where we can afford one and I think it would be a tremendous help to me. As well, my mother is always fascinated with medical diagnostic equipment and eagerly participates in discussions of her health from a numbers perspective. In case you're wondering, yes, I'm always truthful about her numbers and do not keep anything from her when speculating about what they might mean. I find that she retains a remarkable ability to refuse to take these conversations so personally that they worry her. Which, I suppose, isn't a surprise, as she continues to believe in her own immortality.
We picked up a DVD copy of the mini-series Shogun. It has been one of my mother's top favorite TV mini-series since it first aired. At that time both she and my father had read the book and both watched the mini-series. I also remember her mentioning to me, when I lived in Seattle, that she was able to watch the series again in rerun. Soon after I moved in with her it played again and we watched most of it. Well over a year ago, when we began collecting DVDs, something, a commercial for yet another rerun of it, I think, caught her eye and she mentioned that she'd like to own it if it is ever released in a DVD version. I noticed it today at Costco and picked it up. The funny thing is, she didn't remember it. However, we began watching it tonight after dinner and she was transported. She confused it with her fairly recent viewing on cable of The Last Samurai and insisted a couple of times that this or that scene had been duplicated in "the other one we saw recently." After attempting a couple of times to retrofit her memory I gave up. I suppose I should put that one on our list of DVDs to purchase although I hadn't thought, at the time, that she'd found it interesting enough for us to own it.
We're having a minor problem with a glob of wax in her left ear that I can't seem to dissolve or dislodge with Debrox. I used it once yesterday and once today. I haven't yet irrigated her ear after inserting the drops, as she hates this particular step and up to now it hasn't been necessary. If the plug in her ear doesn't appear to be relieved by Monday I'll call her doctor and make sure a note is made on her chart that she needs her ears cleaned professionally again. That's what we had to do the last time this happened three years ago. When she first complained that overnight her left ear had plugged I raced through all the possibilities and checked her out for infection, etc., but none of those seems to apply. It's been very frustrating, too, because her hearing isn't all that good, anyway, and I've had to increase my already resonant volume in order to get her to understand almost everything I say to her. I know it's frustrating for her, too. I hope tonight does the trick.

Well, the bread is done, time to pack it in.
Later.

Here's a worthy problem for the engineers among you...

2005-10-29T11:44:00.000-07:00

...the solution for which might also generate a tidy sum of change: Mobility assistance devices for the Ancient and/or those suffering from dementia-lite (or, perhaps, even full blown dementia). Let me explain what I mean.
    Yesterday we did indeed purchase a claw-bottom cane (it goes by another name but the proper nomenclature escapes me, at the moment). The seller counseled us on its use, humored us with a good 45 minutes of Mom/cane practice before we decided to purchase it and I was able to extract an agreement that we would fool with it over the weekend and if we decided it was inappropriate for her we could return it for a full refund on Monday. Considering its reasonable price, despite what transpires this weekend we'll probably keep it but I asked for the return consideration because the one thing we don't need around here is yet another item that we don't use. We barely have room for the items we do use.
    My mother's first difficulty with the cane is a common one: She couldn't divest herself of the "natural" inclination to use the cane on the weak side of the body, despite the fact that, in explanation, she agreed that using it strength-with-strength made sense. As well, although she seemed to have a natural facility for when to lean on the cane she also is going to have to break the tendency to use it as a hiker would use a walking staff: Which is to say, her tendency is to carry the cane for a few steps then put it down at the wrong time and falter when she leans her weight on it. My concern, of course, is that, considering her whimsical short and long term memory loss, even with prodigious practice the use of it will never be natural for her and she and I will both become so frustrated with the necessity for her having to relearn how to use it every time she reaches for it that it will only render itself useful if and when she suffers a truly debilitating injury due to a fall and shows signs that she will heal (mostly) from it. As well, my mother will also have to be divested of the tendency to use it to arise from a sitting position, for which it is not designed.
    I didn't think to fill in the salesman on my mother's permanently but very slowly declining state of health before he began to explain the use of the cane. One of the aspects of both cane and walker usage that he highlighted was that these devices are designed to be used in order for the users to strengthen themselves and graduate out of the usage of mobility assistance devices. Although I should have guessed this from the way my mother uses such devices, I was astonished.
    "You know," I responded, "for all practical purposes, my mother is not going to 'get better'. She is 88, has a variety of chronic ailments which, while well controlled, will eventually take her out and she has periods of extreme lethargy studded with periods of what, for her, is hyper-physical-activity, so she simply isn't going to be graduating off these devices. If anything, there's the possibility, the gods forbid, that she may, if she suffers severe injury from a fall, 'graduate' to constant use of a wheelchair. Besides this, as you can see, she's a little on the light side mentally, now, and using these devices requires constant relearning and constant coaching."
    Before I had a chance to launch into an aren't-there-any query, the guy shrugged. He knew where I was heading. His shrug told me all I needed to know. I couldn't help but recall what MCF, who works with lots of old, disabled and demented people told me, "They all [use their walkers] that way. If you can use a walker correctly, you don't need one."
    In fact, when we visited the pharmacy after our cane session, a fellow who appeared to be in his late 60's/early 70's pulled into the handicapped parking space next to us used a walker. I noticed that he was quite facile with it and was doing all the things right that my mother was doing wrong. I decided to take the opportunity to ask him about his use of the walker, if he didn't mind. As is true of most people who use these devices, he didn't. It seems that he suffered a stroke "a while back" and was using the walker to help strengthen his muscles and reflexes and make it possible for him to once again walk unaided.
    When I commented that his technique with the walker was stellar, he replied, "Yup, I'm almost there. My doctor thinks I should be walking on my own in a month or so."
    I asked him about difficulties he might have had when he started using it.
    "Oh, I was all over the damn thing. I was a sight. Couldn't get out of the habit of pushing it, like your mother is. It still helped, it got me out, but it was a trial, at first."
    I thought about what he was saying while we discussed the features of his deluxe model with hand brakes, a basket, and a seat that could be retracted while the walker was in use.
    "I know this is going to sound confusing but I'm not sure how else to put it," I prefaced. "Did the walker help you use the walker better, or did you do something else to make it easier?"
    I guess no one had ever asked him about this. He thought a minute. "I see what you mean," he finally answered. "Nah, now that I think of it I'd have to say the better I got at my therapy exercises, the easier it was to use the walker the way it's supposed to be used."
    I thanked him and he shot off down one of the store aisles.
    So, here's the problem: Mobility assistance devices need to be invented that truly assist the permanently mobility challenged in the following ways:

They do no require the need to be learned in order to be used effectively. My mother's dementia-lite plight is not uncommon. As us baby boomers age it will become more common. The learning and training that current mobility assistance devices require needs to be dispensed with.
The devices need to be constructed so that they so easily work with the body's engineering and debilities that they truly assist movement, rather than require a whole set of new movements that are unnatural and, initially, at least in some cases (like my mother's), carry the risk of later discomfort and mild strain from the use of the devices.
They should all be extremely light, environmentally insignificant and extremely durable.
They should all work without batteries or some other power source besides the body.
They should be developed with the idea that their use will be permanent.
They should be absolutely mistake-proof. In other words, there should be no way to use them incorrectly to any purpose (like, for instance, my mother's desire to use the cane and the walker as rising assists).

It's entirely possible that within the next century internal mobility assistance devices and procedures will be developed that restore normal movement while requiring no conscious awareness on the part of the user and can be safely implanted even in those who are now considered to be frail and to carry high surgery risks. This eventuality, though, will probably not manifest before many baby boomers are in need mobility assistance and have begun to mentally phase. In the meantime, the entire mobility assistance industry needs to stop shrugging their shoulders at the plight of the permanently mildly disabled with dementia and consider that making movement easier and mistake free for these customers will also benefit the industry.
I have a hunch, too, considering the inventiveness of our species, that the solution is probably incredibly simple and can be cost effective to produce. So, is anyone out there up to the challenge?

First, thank you, Kidneygurl, for the birthday wish!

2005-10-27T23:02:00.000-07:00

    I smiled at the "spa day" suggestion. Oddly, this is something both my mother and I would love. It's probably out of the question for my birthday, as time is a little tight, but, you know, I'm thinking that this might not be completely out of her jurisdiction, especially if I could find one in The Valley during the winter that takes kindly to Ancient patrons. I'm thinking, this might be something I could arrange for just after the new year. Thank you for suggesting it, Kidneygurl! Hearing from you again reminded me that I never responded properly to your comment on my "bug up the ass" essay some weeks ago. I have to tell you, I much appreciated your "right on" comment. You might be interested to know that a few days after you commented, a friend of mine read it and immediately called me to tell me that I was being "unfair". Slipping ecstatically into post-menopausal liberation as I am, I just laughed. She's never been a caregiver for the health challenged, whether Ancient or not. She'll get it. Hopefully, one day, we'll all get it.
    I discovered something interesting on the Cane Front today from a discussion about the issue with our home health supplier through whom we get our oxygen. It seems that, although Medicare will fund one if they it's prescribed, the fellow I talked to said using the benefit for a cane wasn't wise for the following reason: Of the three devices covered by this Medicare benefit, canes are not rented, they are bought outright. When a cane is bought through Medicare it freezes the benefit for five years. Considering that a single shaft cane can be purchased for around $25 and a claw cane (the type that would work best for my mother) costs around $50, it would be silly to freeze the benefit on behalf of a cane when, considering my mother's age, there is a good possibility that at some time between now and her death we may want to use the benefit to provide a more sophisticated wheel chair or a different style of walker than the ones we have. Freezing the benefit for five years, in my mother's case, may very well freeze it for the rest of her life. So, tomorrow we're going to go cane hunting and purchase one outright. I'm familiar with a couple of places that sell them so I'm sure we'll be able to get a good deal. I'm going to focus on places that will adjust the cane, be willing to replace it for free if it's defective, has a reasonable maintenance policy and provides some instruction on usage. At the same time I'm going to check on the availability of oxygen fanny packs and whether I need her PCP to rewrite her oxygen prescription to include these. If she is at all facile with the cane she may very well want to use it outside as well as inside our home, in which case the fanny pack oxygen would come in handy. I can't even imagine how difficult it would be for both her and me were it necessary for me to cart her oxygen around while she was caning through a shopping trip.

    Today, during one of the times when I was replacing and readjusting her elastic knee brace, Mom mentioned, "I'll probably have to wear this for the rest of my life, won't I."
    "You know, Mom, it wouldn't surprise me if you'll have to use it most of the time, especially when we're out, for the rest of your life. I think, probably, every day there will be periods when you're not moving much and you're sitting in your rocker when you can take it off but it's so much easier for you, even moving around the house, when you have it on that, yeah, it's probably a pretty permanent thing."
    We both sat and contemplated the brace on her knee for a few moments.
    "You're not getting any younger, you know, Mom," I said.
    She flashed me a comic sneer and said, "Well thank goodness for that!"
    We both laughed. It is this spirit in her that I not only love but regularly marvel at. Even at her age, with her aches and pains, her phasing and its attendant confusion and her occasional admonitions to me to "never get old", when she's experiencing the worst that Ancienthood has to offer her she continues to cherish the advantages of aging in the same way someone in their middle years does. She has absolutely no desire to go backward in time.
    You just gotta love a woman like that.

    This afternoon for no reason I can think of it suddenly hit me how much I'm going to miss her after she dies. I'd never before thought of it. Up to that moment, every time I've thought of my life after her death I've thought about it in terms of how I'll survive, what hopes, wishes and dreams I might consider fulfilling, etc. Today I realized that she and I have become such a crucial part of each other's lives that the absence of the necessity for all the observational and caring routines I've constructed around her presence will make it seem, initially, I think, as though I'm standing in the middle of a deep, dark hole. I was blown away by this realization. Curiously, instead of causing me to cringe at the possibility of her death, realizing this created, instead, a hunger in me to redouble my efforts to enjoy the hell out of her while she's alive, a sort of minor epiphany, I guess. Not that I hadn't previously considered that this is The Way To Do It, but, you know, I flashed back on all the times when I've felt overwhelmed by the lack of Me Time and suddenly realized there will again come a time when I'll have all the Me Time I can handle. Best not to waste this opportunity to appreciate and participate intimately in Her Time.
    I remember her telling me, after my father died, that, more than anything she felt relief at his passing. I know this is not an uncommon feeling when someone for whom you've been intensely caring and who has had critical and extremely uncomfortable health problems for a long time is released from their agony (which my father was experiencing prior to his death) and you're released from the helplessness of caring for someone in such a state. Although I have no way of knowing if my mother will suffer such agony before her death or simply check out with no baggage, somehow I think that, for me, because of the long journey I will have taken with her, that, even if a certain amount of relief is involved, my overwhelming reaction will be temporary bewilderment at her definitive absence.

    She continues, by the way, in ruddy, energetic (for her) good health. Early this evening when she laid down for her nap she asked me to awaken her in an hour.
    "I'll do that if you want," I said, "but you've been doing really well, lately, lots of moving around. If you decide to catch a little more sleep time, I think it'll be okay."
    "No, I don't want to miss anything," she said.
    She did, in fact, come to immediately when I awoke her exactly an hour later. "I'm ready for the evening, now," she said.
    "We don't have anything spectacular planned, Mom, just dinner, trimming your nails and maybe some hot games of Sorry."
    "That's enough," she said.

    Tonight she spoke of my father as though I hadn't known him as my father but only as her husband. We were watching some minor program on television and one of the actors pronounced the word "either" with an initial long "i" sound: "Eye-ther".
    "[Her husband] heard that pronounciation once on TV, picked it up and nearly drove me crazy pronouncing it like that from them on."
    Since Mom also has a grandson who's named after my father I wasn't immediately sure who she was talking about. "You mean your husband?" I asked.
    She looked at me as though I was losing my mind. "Of course. I know you've met him."
    "I dare say I have, Mom," I said, chuckling, "considering that he fathered me."
    She did a double take. I watched her expression kaleidoscope as she silently reoriented herself regarding who I was and how she and I were related. Finally she said, "Oh, yes, that's right. You're mine."
    I continued the discussion, recalling for her the time, decades ago, when all of us were gathered at a table at our temporary home in Spearfish one evening while my father read to us descriptions of Guam, to which we were shortly to relocate. My father had spent even more years previous meticulously divesting himself of his thick North Carolina accent but there were a few dialetical idiosyncracies he never dropped: One was pronouncing "can't" as "cain't". Throughout his oral presentation I continually interrupted him, wanting to ask him a question. He put me off until, finally, in a frustrated attempt to silence me, he asked me what I wanted.
    "Why do you say 'cain't', Dad?"
    Mom and I both laughed recalling his exasperated, silent reaction and talked for several minutes about his life-long battle to keep from being recognized as a Poor White Trash Southerner.
    Throughout the entire discussion my mother's words of recognition to me, "You're mine," echoed through my head. When we finished with Dad and sat back satisfied with this particular memory, I couldn't help but smile broadly and think, "Yes, Mom, I'm yours. How lucky I am."
    Mom noticed me smiling and said, "You really enjoyed catching him on that, didn't you?"
    "Well, yes, but not just that..." I reached out and patted her arm.
    She put her hand on mine and said, looking simultaneously far away and close up, "I know what you mean..."
    We had a very good night tonight. I think its aura will enhance the rest of our days together. How truly lucky I am.
    Later.

I continue to run a half to a whole day behind...

2005-10-27T11:58:00.001-07:00

...on statting but I'm getting everything in without having to search my memory for what we ate for dinner three nights ago.
    Last night's dinner stat review also includes a run down of our evening which included yet another trip involving both getting out and walkering. I'm so surprised, and pleased, that the activity in which I thought she'd indulge during the summer is happening now. She's, as usual, taking well to walkering, now that she's doing it every day. I make sure, too, that she wears the elastic knee brace all the time, now.
    Something I want to mention regarding elastic knee braces. I discovered that the size that is supposed to fit her, "Medium", is too tight for her. It irritates her skin and is too small to put over her pants in order to keep her skin from being irritated; I'm assuming this is more true for the elderly than those not yet elderly. As well, when she was using the "Medium" brace her right foot swelled a little more than I'd like every time, which means it was restricting fluid flow throughout her body from her extremeties. So, we use the "Large" (there is also an "X-tra large", which is much too big). When fitted over her pants over her knee, it provides exactly the right amount of support and neither irritates her skin nor promotes foot swelling. The funny thing is, her knee measurement comes in right in the middle of the "Medium" measurement but for her this wasn't adequate. If you're dealing with an Ancient One who needs elastic extremity support and you're having trouble with sizes, try to find braces that come in at least four sizes and try the size larger than the one indicated by measurement. As well, putting it over clothes sometimes works better than placing it brace-on-skin.
    All arrangements that need to be made for our trip to The Valley next Tuesday have been made. I've decided to try this trip without renting a hotel room for the following reasons:

Because her appointment is set for 1400, we'll be leaving a little later than usual. Thus, I'm planning that we'll simply stop for lunch (and a bathroom break) immediately upon arriving in the Valley. As well, she and I both are interested in visiting Ulta. There's a shampoo I use that can't be ordered from their internet site on which I need to stock up and Mom always likes to peruse their Christmas displays. We'll probably purchase one of their super-duper manicure kits for her, too, since she eyed those the last time we were in The Valley but didn't think she "needed" it at that time. Since then, a couple of her manicure tools have broken so I've insisted that she does, now, "need" a new manicure kit and we may as well get the one she likes.
By the time we're finished with the above, it'll be about time for her appointment. She'll be able to refresh herself at the doctor's office and routine doctor's appointments with this PCP always energize her, primarily because this PCP is so respectful of her.
The last time we performed this doctor's routine followed with plans to visit MCF after the appointment (which we'll be doing next Tuesday), she was completely uninterested in taking a nap at the hotel. In fact, she didn't take a nap all day; she was primed for all aspects of tripping. So, I figure, we'll just go directly to MCF's from the doctor's office and spend the evening in excellent company. I'll bring along a plastic sheet if she decides to nap but she I doubt we'll use them.

    The nice thing about not getting a hotel room is that our traveling supply inventory will be cut in half, thus cutting my prep time by about as much.

    I love these "health honeymoon" periods she experiences. I hope I can keep this one going as long as possible, at least through the holidays. At my mother's suggestion, we're going to be doing some holiday baking experimentation this week and weekend before the trip. She wants to be able to present MCF's family with a holiday treat tray when we visit. Although she doesn't directly "help" when I cook and bake, now, she loves to supervise, especially when it involves sugar.
    Except for minor errands that apply only to me, like having my hair trimmed, which I did early this morning, I'll be taking her on all necessary errands from here on out, too, without giving her a choice (unless she is clearly under the weather on a particular day). This should help keep her going, as well, and she seems to be able to take it right now. As well, if we're able to procure an Rx for a cane this will probably involve some visits from the Assistance Device company to determine which model would suit her, probably some adjustments and hopefully a session during which she (and I) will be educated in how to use the cane to her best advantage. This will perk her up. She always enjoys the attention these appointments allow.
    I attempted to rouse her a little over an hour ago and she wasn't having any. That's fine. She was up late last night: We both got hooked on a couple of programs on PBS that lasted until midnight. After that, I noticed that her light didn't go out until 0030. So, I'll let her sleep in while her muscles reconnoiter from yesterday evening's activity.
    I'm doing pretty well. I had a short, mysterious "Ohmygod, I can't seem to find any time for myself right now and I need it" period, yesterday afternoon but it dissipated quickly and I was more than rewarded by the very successful evening trip Mom and I had and the extra energy it catalyzed in her. Well, maybe not so mysterious: My birthday is Monday and, once again, I'm feeling particularly uncelebrated. I'm still debating whether I'm going to even remind Mom of my birthday and/or suggest that we go out to eat; I'm again feeling pretty much the same way I felt last year about celebrating by going out. We'll see. In any event, it looks like I can get in a little self time today.
    In case you're wondering about the much spoken of index, it's been almost two weeks since I've had the time to get back to finishing off the cataloguing process. I'm hoping to pick up on that soon.
    Whoa. The Mom's up.
    Later.

Mom's Health Review: 8/30/05 - 10/24/05

2005-10-25T16:35:00.000-07:00

Blood Pressure:
Dynamic within the last month. As the chart indicates she has frequently received three 2.5 mg lisinopril tablets a day; occasionally four. I'm thinking it might be time to rewrite her Rx to: Three to four 2.5 mg tablets a day. I don't think she's ready for for a constant 10 mg per day but starting today I'm going to try her for a week on a constant three per day and see if this evens her out. It is primarily her systolic pressure that's been dynamic, so much so now that I can no longer predict on any given day if it's going to be high or low, nor can I attribute highs to anything in particular.

Blood Sugar:
Very good control.

Urinary Issues:
Incontinence continues but not as prodigious as previously. In the last two months she's had a couple of nights of no leakage through her paper underwear and has not leaked through her paper underwear during the day at all. Macrodantin is keeping her UTI free.

Hydration:
Not sure why, but we seem to be doing better with this: Not too little, not too much.

Energy Level:
The perking up I expected in the summer is happening now, to my surprise. Although she continues to sleep 12-14 hours a day, she is more active than she has been for awhile.

Skin & Circulation:
Both appear to be excellent.

Appetite and Diet:
Both remain excellent. No changes.

Dementia:
Remains unchanged.

Will & Spirit:
Remain strong and high, respectively.

Medication & Supplements:
See Blood Pressure for report on lisinopril. She is now taking 1.5 tsps Benefiber® daily. No other changes. Within the last three weeks I've administered 200 mg ibuprofen to her twice in order to alleviate muscle aches from accelerated movement. It seems to work better on her than acetaminophen for muscle aches and since she's on the Protonix I figure, infrequently and at minimum dose, it's better for her than acetaminophen because acetaminophen tends to elevate her blood pressure.

CHF:
I've only had to administer furosemide once in the last two months. I've reinstated nightly foot and leg rubs, which seems to help, although, as noted above, her blood pressure's been shooting all over the map lately, especially her systolic readings.

COPD:
Remains a non-smoker (Yay!). Her oxygen usage has dropped a bit during the day when she's sitting; if she's not mouth breathing I don't hook her up to it. When moving outside she's on 2-3/lpm pulse, mostly; I switch her to continuous if she starts mouth breathing. At night she's on 2/lpm continuous. When doing exercises I continuouson 2/lpm continous.

Bowel Movements:
No constipation or diarrhea this period. Continues to eliminate every 24-72 hrs; usually every 48 hrs. Fecal consistency, volume and ease of elimination remain excellent.

ADDITIONAL NOTES:

Nice labs this month, especially her hemoglobin!
I keep forgetting to mention: Her marginally low SGPT from her CMP of 7/26/05 is probably due to the 12 oz. cup of detox tea a day to support her kidney and liver functions. One of the primary ingredients is licorice root which is apparently famous for lowering SGPT.

ISSUES TO DISCUSS AT APPOINTMENT:

The advisability of rewriting her lisinopril Rx for three to four 2.5 mg tabs per day.
It might be time to prescribe a cane to help her get around the house. Both her walker and her companion wheel chair were gifts from friends who died so Medicare/TriCare isn't yet being used for assistance devices. She does well with the walker outside but our house is small and narrow and has a few steps into and out of the living room. She's getting to the place where she could use some assistance walking around the house, especially on days when she is primarily immobile. She is not, by the way, in favor of the idea but little by little she is less sure of herself on her feet, primarily on her right side, which is the side affected by the years' ago mini-stroke.
She needs a flu shot. She had a pneumonia shot in 2000. I'm not sure if it's time for another one, yet. Also, either this appointment or next I'd like her to receive a tetnus shot because our yard is pretty wild and the possibility of puncture wounds if she falls is high.
Any issues of concern to you.

I'm done with all the reporting...

2005-10-25T16:13:00.002-07:00

...it's been faxed to her doctor and I am pleased to announce that my first faxing on our relatively new fax/printer went without a hitch. It's nice not to have to traipse to Staples to do my regular faxing. I'll be posting her current health review shortly.
    Despite her arising in the peak (for her) of "vim, vigor and vitality" (one of her favorite phrases), as bathing and breakfast drew out she began to notice an ache here, a twinge there, surprising stiffness elsewhere. No wonder, considering all the movement she's accomplished in the last few days. Although during breakfast she was still up for a trip to continue searching out cookie cutters, by the time she'd finished her detox tea she'd decided she'd rather not go anyplace today. By 1520 she opted for a nap. I didn't fight her. Often, when she retires for a nap this early after a late rising, she doesn't sleep soundly, she dozes and then is up in an hour or less. I just checked in on her a few minutes ago, though, and she's laid out as though for her own wake: Eyes shut tight, stretched out all over the bed, face expressionless.
    So, it's going to be a slow day, today. That's okay. I'm so relieved with her lab results I don't care. Because of her bouncing blood pressures and her summer lethargy I was concerned that something new was going to be way out of balance. I'd even been considering (discussed some days ago over at Mom's Daily Tests & Meds) that we might be turning a corner in her Chronic Renal Failure and leveling out on a lower plateau (the link will take you to the specific post). In line with this I was thinking that her potassium and sodium might be collecting, thus she might have high readings on either of these and her creatinine might be starting to slip out of normal range. Everything's normal, though, and there are no unusual spikes in her normally high BUN, either. I guess she just has her own slow, steady, leisurely way of being old.
    Well, let me upload the current health review.
    Later.

Back in the Low-High Life Again.

2005-10-25T10:21:00.000-07:00

    Well, I'm ecstatic. I just uploaded her blood draw results for yesterday. They are practically a repeat of her results for 4/13/05, which was a "very good year". Aside from her hemoglobin skirting normal range for Mesa, all her other out of range CBC results are normal for Mesa. Her BMP results are also comparable. I noticed something curious, too. The last time her Fasting Blood Glucose was high in the morning for her blood draw was also 4/13/05. Don't know that this means anything, but I find it interesting.
    This morning I'm compiling all those reports I normally fax to her doctor monthly. Last month I compiled them but forgot to send them. I don't think it's a problem. Little has changed except that I think her blood pressure has experienced more highs than the month previous, although I'm not sure, yet, as I'm not finished compiling that report.
    I'm not sure what's on the agenda for today other than reporting to the doctor. Although Mom went to bed fairly early last night, I'm letting her sleep in because she engaged in a lot of activity yesterday and I'll bet her muscles are reorienting themselves. I just checked in on her and she's stretched out lazily on the bed, breathing deeply. She had suggested that we try out the spritz cookie press last night but just wasn't into it when "the time" arrived.
    Well, back to work. Once I compile and fax the reports to the doctor I'll be publishing her health review for the last two months, here.
    Later.

No/Yes Day.

2005-10-24T15:19:00.000-07:00

    Wow. I didn't realize it had been so long since I'd reported here.
    I awoke in "No" mode. I'm not sure why, but suffice it to say that my first "No" was to the planned blood draw. I just didn't feel up to the extra energy it takes to ready Mom, get her there, get her blood drawn, take her out to breakfast as I promised last night, get her home and get her settled.
    My mother, as it turns out, slept into other plans and awoke early on her own. At 0945 she surprised me, toddling out of the bathroom to ask me if today was the day she was to "donate blood". That's when I provisionally switched to "Yes" mode. Why not, I decided. May as well. She's up for it.
    On the way to draw blood she began fantasizing out loud about what she was planning to "order for breakfast". This clued me that she'd remembered my after-blood-draw-restaurant-experience promise. What the hell, I thought. So we don't have her medications. It's not like she's on nitro or something equally critical. So her blood pressure and blood glucose are a little high. She's not in stroke-out or diabetic-coma range. We'll pill her up when we get home.
    My, but she was energetic. She surprised me with her elan using the walker both at the lab and at the restaurant. The hostess who intended to seat us asked if it would be better if she seated us in the front room. By this time Mom had already turned her walker toward the dining area and was halfway through the front room.
    "Well," I told the waitress, "it looks like she's got lots of energy today. May as well take advantage of it. You can seat us where it's most convenient for you." We were lead to a table in the middle of the back room.
    Mom thoroughly enjoyed herself, ate heartily, appreciated the restaurant environment (we were seated facing a western window bank displaying trees that were in full fall-red) and chatted about the various people in the restaurant.
    After we ate I decided to explore her energy level. "So, Mom, do you want to go to that hardware store with the great kitchen section and look for cookie cutters and a spritz cookie press?"
    She was more than game.
    Although she didn't exactly wander all over, she chose to sit on her walker in front of the cookie cutter display and examine all the choices, all of which she nixed, mostly because of price (she tends to think prices should still be at the level they were in the 1940's and 1950's), she was very taken with the cookie press I found. After I'd located all the items I had listed, she insisted on heading back to the cash register through each of the cooking section aisles to marvel at the gadgets.
    It didn't take her long, once we'd arrived home, for her decide that a nap was in order. After her detox tea and the rest of her pills she shuffled into bed. I asked her if either her back or her knee were bothering her. She reported that her knee was "a little iffy" but not enough for any pain reliever. Her back, she said, was "just fine."
    I was blown away, and glad that her "Yes" mode had a 180° effect on my "No" mode. Friday and Saturday she'd decided to turn into sleep days. Yesterday, when I was finally able to talk her into a little movement, although we did go to Walmart and got her a stunning Timex® watch, she was not at all spry, was a little confused and was not interested in doing anything else but buy a watch, even though I'd suggested we look for cookie cutters there. As it turned out they didn't have any. She did, however, stop at a Christmas cup display and select a cup that looked like a wrapped gift, the handle being shaped in a sideways bow, to use for her coffee during the Christmas season. When we arrived home she was stiff and sore and out of sorts and took such a long nap she had only two meals and a banana.

    I want to mention, for the record, that I got my flu and my last pneumonia shot on 10/20/05. It seems that, after 1991, according to one of the nurses at the pharmacy where I was inoculated, the rule is two pneumonia shots five to six years apart and you're done for life. Interestingly, although I never react to injections, I really reacted to them this time. I was out of it for almost two days, feeling as though I was suffering from a mild case of the flu. In addition, the arm in which I received the pneumonia shot ached for the entire 48 hours. I'd been apprised of both these possible reactions by the injectors but I didn't expect them, since I've never had a problem. In fact, for the first 24 hours I couldn't figure out what was going on until my mother reminded me of the shots.
    Mom'll be getting her flu shot at her routine doctor's appointment on November 1st, even though I've read in the last week that it's been discovered that flu shots are not particularly effective for preventing flu in the elderly, although they do seem to affect the incidence of pneumonia. Apparently, in the elderly who receive flu shots there is a 30% decline in pneumonia rates. I wish I could remember where I read this; I'd cite the source. At any rate, other than this shot, she'll also be receiving either a pneumonia or a tetnus shot. There's some question as to whether Medicare will allow her another pneumonia shot this year, since her last one was in 2000 and typically they only allow for a pneumonia shot every 6 years. TriCare, though, may trump Medicare in this case. If not, I'll see to it that she gets a tetnus shot, just because our outside property is loaded with all types of possibilities for puncture wounds. There is another rule, I'm not sure if it's official ounofficialal: Only two shots at a time. If this rule kicks in at her doctor's office and she is also eligiblele for the pneumonia shot then we'll get her tetnus shot at her next schedule routine doctor's visit, which will probably be late February/early March.
    At pharmacy, in line for my shots, I was behind a group of three people: A woman who was 91, her husband who was 81 and the woman's daughter who was 62. I struck up a conversation about the 91 year old woman with her daughter. Although she does not use any type of mobility assistance devices her daughter told me that she should (which was obvious to me when the mother moved around) but she refuses. She is also touchy about a proffered arm. The 91 year old looked very much like my mother: Small, slightly bent and full of much more determination than her body appeared to be able to manage. The daughter mentioned that her mother was suffering from "slight dementia", which she described as much like my mother's (time phasing, people phasing, environmental phasing). Her daughter also mentioned that her mother has "advanced mobility issues" which cause a problem within her marriage: Her husband, at 81, is vigorous and capable of getting around without a problem, and does. Although not overtly resentful of his wife's disabilities due to age, the daughter believes that, deep down, he is not interested in the extra negotiation he needs to perform on his wife's behalf.
    "It's the little things," she said. "He goes crazy when she repeats the same stories over and over. He stopped mediating for her at the doctor a long time ago, so I take her, now. He gets out a lot more than she does and 'forgets' to call me to stay with her, so I call them every day to see if he plans to leave her alone. If he does, I go over. He refuses to believe that she is in danger of falling, even though she suffered a bad fall a couple of months ago. He's got a reunion coming up in Washington in January. I'm sure that it's not a good idea for her to go but he keeps insisting that she must go and she continues to believe that she's able. I'm going to insist that she stay here and move in with my husband and me while he's gone. I know it's going to be like pulling teeth to work this out, but I know they'd both be better off if he went alone."
    I contemplated that there are some elder care situations which are much harder for relatives to negotiate than my mother's and mine.
    When the daughter stepped up for her injections, the mother, who was done, and I chatted in the spaces between the loving, teasing banter between mother and daughter about how the daughter would react to her shots: The mother seemed to remember that this daughter had to be coaxed and comforted through injections while the daughter worked hard to try to remind the mother that the daughter being remembered wasn't her, it was another sibling.
    The mother joked good naturedly about how one's children remain children "right up to the end." I mentioned to her that I imagined this was true, although I'd never had children.
    The mother looked startled. "Oh, dear. You couldn't, I suppose. How sad."
    "Well, no," I corrected, "I didn't want to. Didn't even get married."
    Suddenly the mother's face turned red with excitement and focus. She moved in very close to me and put her hand on my arm. "Oh," she said, "I always wished I could have gone through life without children and a husband. I almost thought I'd get away with a little freedom after my first husband died. But this guy," she nodded toward the man who was her second husband, "pleaded with me and he obviously needed someone to take care of him. What are you going to do?"
    I quickly surveyed both her daughter and her second husband. They were both looking at her with astonishment.
    At this point her daughter, trying hard to make the question into a joke, asked, "Mom, are you saying you wish you'd never had us?"
    The old woman laughed. "Well, of course not, dear! I treasure you and your sister! But, you know, if things had been different, I wouldn't have regretted it..."
    Ahh, the secrets of The Ancients. You just never know when they're going to fall out of an Ancient mouth and change everyone's perceptions.

    This morning, by the way, while we were bathing my mother she asked me if I'd been "on the phone" when "[her cousin with the never-an-indoor-voice]" called "yesterday" and mentioned that "one of the fellows [my mother] dated in high school finally got married and had twin boys."
    First I asked her some detail; what grade, what was his name, did he ask her to marry him. She couldn't remember. Then I decided to tell her that the phone call probably happened some decades ago and the man, if still alive, was probably both a grandfather and great-grandfather of twins, by now, maybe even a great-great-grandfather. She was, as usual, astonished.
    The interesting thing is that last night she remembered "a fellow" she dated before she went into the Navy who took her to Chicago one evening for dinner. I'm not exactly sure if her detail, other than having dinner in Chicago with someone, is accurate: I'm thinking she may have been in the Navy; stationed someplace other than Iowa, since she insisted that driving to Chicago only took them "about an hour"; and it was either before she met my father or, in fact, "the fellow" was my father, before they married, although she denied this.
    I'm not sure why she's remembering her swains, lately, but it's fun to discuss her dating life with her. Apparently, during this dinner, she decided she loved Chicago. She mentioned, last night, that she'd like to live there. I didn't respond, except to nod.
    Okay, let's see. I think I'm pretty much caught up. Not sure if I'm back in a predictable saddle, again, as far as posting is concerned. We'll see...
    ...later.

At least this year...

2005-10-19T11:05:00.000-07:00

...I'm not writing about it. That should be consolation to some.

I've been a bit tardy reporting, here.

2005-10-17T11:14:00.001-07:00

    It hasn't been intended but Mom and I have been spending so much of her up time in animated conversation or watching a few new videos I've purchased and I've been spending most of her sleep time doing errands outside of the house that journaling time has simply gotten away from me.
    I haven't been able to get her out but I'm pleased to say that her nap times have been under an hour and she's regularly been going to bed close to or after midnight. This has been surprising me, as we've had a low hovering over the area since late Saturday. She usually spends low days in bed.
    She's having an episode of high (for her) blood pressure. I'm thinking that it may be time to have the doctor switch her lisinopril prescription to 2.5 mg three times per day or 5 mg twice a day. I'll give it a few more days and see how things shake out.
    Sometime this week our new range is due to be delivered. Yesterday afternoon, although the entire compliment of holiday baking magazines hasn't hit the stands, I picked up all I could find. When we weren't watching Sleepless in Seattle Mom pored over the magazines as though her life depended on it. I mentioned to her to turn the corners down on those baking recipes that interested her. I swear, all four magazines are so dog earred they hardly close! Last night I mentioned that we won't be doing actual holiday baking for about a month or so but we'll need to do some dry runs so I can get the hang of using the new oven.
    "We'll need to do lots of dry runs," she said.
    I'm very, very pleased we're planning on baking for the holidays this year. I have a feeling lots of acquaintances and friends will be pleased, too.
    If I had the motivation I'd be reporting more (nothing worrisome) but my journaling motivation seems to be lacking, at the moment.
    Later.

Strange days, I guess...

2005-10-15T18:08:00.001-07:00

...is my excuse for not recording here for some days. Part of my lack of journaling diligence is due to company but part of it is due to a dreamy mood I've been in since just before the visit. Can't really explain the parameters of the mood except that I feel as though something is percolating inside me but hasn't yet reached the surface, so I've been doing all sorts of other activities in order to allow that something it's "space".
    The visit went well, although some definition is needed here and will be forthcoming. There was an incident that provoked some very specific thoughts about relatives who are uninvolved in caregiving attempting to "help". I'm working on that post over here, although when it's done I'll probably transfer it to the essay section.
    Something, though, I want to mention before I forget for my own reference: MPS told me the history of a man of whom she knows through the daughter who is taking care of him. He is An Ancient One who "suffers", as does my mother, from Anemia Due to Chronic Disease which was most likely pre-diagnosed as Iron Deficiency Anemia. MPS related to me that his anemia is treated with frequent (every couple of months, sometimes more) blood transfusions. The man's daughter reported to MPS that at first he always felt remarkably better after the transfusions. As time pssed, though, this changed. He is now at the point where he feels worse immediately after the transfusion, a day or so after receiving blood he revives a bit then continues his downward anemic trajectory and, as well, he hates the procedure. MPS explained that this is typical of people who are receiving frequent transfusions. Here is my interpretation of her explanation: Blood is rather like an organ in that outside blood can be rejected and the blood can (and not uncommonly does) carry foreign agents which can deleteriously affect the health of the transfused. As well, transfused blood can cause the body to work hard to protect itself from a build-up of "antigens", a build-up which is impossible to prevent in the case of transfusions. Thus, while the transfusions may elevate one's anemia indices, each transfusion also elevates the level of internal physical stress and strife and, transfusion after transfusion, make a sense of physical well being harder and harder to come by.
    In the case of my mother, knowing this information is a great relief to me. I am sure, now, that I am handling her anemia as it should be handled for her. Although there are risks, as well, to continuous high doses of iron, for my mother these risks are much easier on her than the continual transfusion scenario outlined above.
    Since MPS related this to me I've wondered:

Whether the man was ever treated with iron supplementation and, if so, was he treated with anything besides ferrous salts which, although they are currently physician's favorites are also the hardest iron supplements on the body and have the lowest absorption rates;
Whether this man and his daughter experienced medicine's ridiculous insistence on "looking for internal bleeding" in the elderly with chronic anemia and whether and how far they assented to it?
Whether either the man or his daughter have looked for alternative sources of information on Anemia Due to Chronic Disease and treatments for it?
How long it took medicine to finally back off and identify his ailment as Anemia Due to Chronic Disease?
Whether it was a physician who finally backed down or whether it was some other medical professional, like my Wondrous FNP, who has less invested in leaving a diagnosis open.

    I wish I had thought to mention the above to MPS before she left. I know I'll approach her again about these concerns. She may not know, but it certainly won't hurt to ask. Of course, the gods only know when I'll get a chance to ask her.
    Mom isn't exactly recovering from the visit anymore but today has been a very low key day for her, as was yesterday. We've been watching videos and she's been "catching up" on her sleep. I'm hoping to get her to Walmart tomorrow to pick out a new watch. She magnetizes all but Timex watches and Walmart has a fair selection of this brand. When I suggested this to her earlier her response was, "We'll see." Not promising, but today is not tomorrow.
    If you've been to Mom's Daily Tests & Meds you'll notice I'm a day or so behind. I'm hoping to make stat ketchup tonight. In case you're wondering, her blood glucose has been doing fine but she's having an episode of elevated (for her) blood pressure, although it doesn't appear to be connected to a CHF episode. Could be because she's a bit backed up. If she doesn't have a significant bowel movement this evening I'm going to send her to bed with yet another dose of laxative; haven't decided yet which one.
    I've also got a few more entries to make in Movies, Mom & Me. Maybe I'll get to all this sometime this weekend. Tonight, though, my plan is to do Mom's hair and talk up the possibility of A Walmart Experience tomorrow. My dreaminess has involved me retiring earlier than usual after Mom retires which truncates my journaling. This may continue to be the case tonight.
    Strange days, I guess...

I guess what I've got is a slow cold.

2005-10-11T10:51:00.000-07:00

    I've been fighting congestion for a couple of days but it always seems to disappear in the evening, although I've been extraordinarily tired late in the day, usually dozing on the couch between Mom's lunch and dinner. This morning I awoke because I could barely breathe. I'm dosing myself with Mucinex and ibuprofen and using way more Kleenexes than I typically use in a week. My energy level is extremely low this morning; lower than last night and it was really low last night. I'd consider this unfortunate, because MPS and MPNC are on their way up for an impromptu two night visit, but I don't even have the energy to care whether or not I'm easy to get along with. We are out of Supplies for Company. We don't even have enough bread, I don't think. When I picked up their message yesterday of their impending trip and called MPS I told her I'm not going to prepare for the visit. She's fine with this.

    Mom worked herself into a snit over the No Toilet Paper in Her Bathroom issue late last night. It continued throughout the night. She insisted that "company" wouldn't know not to use her bathroom or that they'd forget. I insisted this was not the case. Everyone who visits regularly knows better than to use Mom's bathroom for a couple of reasons, the No Toilet Paper Issue being of the highest regard. She awoke me several times in the night getting up, trotting into her bathroom, peeing, searching for toilet paper, then hauling her Kleenex box into her bathroom. I'd wait for her to resecure herself in bed then I'd get up and take out the Kleenex box. Two times she hadn't yet settled in bed when I cleared out her bathroom and we had short, angry exchanges about the lack of any paper in her bathroom.
    This is probably one of the touchiest, most difficult issues I face with her: Insisting that her personal dignity stand down so that I don't have to unclog her toilet every day to every other day and she doesn't become prone, again, to UTIs. I think the reason she has so much trouble forgetting this and what I do on her behalf (cleaning her, making sure her toilet doesn't stop up) is that this is truly an issue she doesn't want to remember.
    I have no idea what we'll do with our company over the next few days. I know we'll have to go to Costco and a couple other groceries. I've been letting our stocks dwindle so there is more room in the freezer for half eaten loaves of home made bread. However, we've almost polished off the last of the bread. We need more salad stuff. I think we've got plenty of meat, although MPNC is vegetarian so we're pretty much out of what she eats.
    As time nears for their arrival I am in no better spirits than I was when I arose at 0845. Mom, of course, will be in high spirits. This should be a very interesting visit.

I'll be checking in later.

2005-10-10T08:57:00.000-07:00

    I've got stats for yesterday but not much to report. Yesterday was an extremely mellow day. Nice.
    I'm in the process of adding a guest book. So far it's not working. I'll keep you posted about its development.
    The guest book has been deleted. News to follow.

I am, by the way, motivated by the idea...

2005-10-09T12:04:00.001-07:00

...of grunt work today. I'll probably fix broken links over at the movie site as I get the time.

Although an important piece of business was accomplished...

2005-10-09T12:03:00.004-07:00

...I, again, washed out yesterday. I definitely felt "coldish", although I'm doing better today. I dozed on the couch throughout the afternoon and early evening while Mom took an "unsupervised" (no oxygen, no double underwear) nap, arose, turned on the TV and watched a good hour of the Dog Show before I became marginally aware. I cover what we ate, which was little, in the last post for yesterday. I revived a little yesterday night and remained awake until almost 0400 this morning. Mom light-off retired at 0130. If you're wondering why I consider that she hasn't retired unless she is no longer reading in bed, it's because for her, reading in bed is an activity. It is not uncommon for her to call me in to read a passage to me, which is why I always remain up until she turns off her light.
    I slept through the showing of a gorgeous Newfoundland, although the showing also occurred through a commercial and was only thumbnailed. Too bad. This dog was a luscious bitter-sweet chocolate color and had a very alert demeanor. I would have loved to see this dog in motion. I don't think this year's Newfoundland even made place or show. If we get a dog, this is the kind of dog we'll host.
    The Little Girl loves to watch The Dog Shows. Funny, she doesn't find cat shows interesting. Although she loves reptile shows. She watches small high desert reptiles in and outside our house.
    Movies, Mom & Me is updated, at least from the standpoint of listings. I discovered that I need to change some links within the descriptions on that site.
    Fall is slinking in. Some trees are changing. Most aren't. Today it looks as though we'll have our first day in the high 60's instead of the low to mid 70's. I dressed Mom warmly yesterday but she refused a coat or scarf. I insisted on the wheelchair. She was eventually grateful.
    I'm waiting for the announcement of the Best in Show then I'll sign off. This year they've attached microphones to the judges and top showers. The "informal" conversation is interesting. The judges, across the board, make contact with each entry. These people love dogs.
    This year I like the PBGV and the Japanese Chin.
    The Scottish Terrier looks good, too.
    "She's asking the dogs to turn it up as well."
    Cool!. Ahh. It's the shepherd. Wow. Beautiful dog. Great attitude. Definitely "on" tonight. Wonderful relationship with her (Tina's) handler.
    Haven't yet decided what to do about rising time for Mom. She'll hit 12 hours at 1330. I'll play it by ear. She may already be rousing out of the depths of her pleasant, Mid-Central U.S. dreams.
    Later.

We've bought the new range...

2005-10-08T17:26:00.001-07:00

...delivery to happen in a week and a half or so. The only minor argument we had was over the color. I leaned toward black, since black appliances make our tiny kitchen look larger along with the dangerously dark cabinetry. Also, as I discovered with the purchase of black stove element pans some months ago, black looks cleaner when it's not clean than white, bisque or stainless steel stuff. I held my ground and Mom finally gave up, saying, "Well, you're the one who's going to use it."
    True.
    As usual, Mom was very animated while conducting business. The sales associate understood, though. She looked to be about my age, maybe a little older, and familiar with the circumstances surrounding doing an elderly parent's business while allowing them to feel as though they're doing their business.
    Last night, in our first anticipation of using a reliable oven, Mom and I began a very stringent holiday baking list:

Molasses-Ginger Snaps;
Gingerbread with chile powder;
German Chocolate Cake Cookies;
Banana Bread
Mexican Wedding Cookies
A few candied fruit fruitcakes from my mother's recipe;
a few more dried fruit fruitcakes from my recipe;
Traditional Family Recipe Date Bars;
Kolachis with dried peach and fig centers;
Pound Cake to be soaked with Chambord
Egg Nog Bread;
Toffee Chocolate Chocolate Chip Cookies;
Honey Bear Brownies;
A lemon-oat-streusel bar using lemon curd;
Some kind of bar using Robertson's Scotch Marmalade and dried cranberries;
Peanut Butter Cookies;
Spritz Cookies
Oatmeal Apricot Cookies.

We may add something to the above list here and there. We will definitely not be subtracting anything. I'm considering attempting to make fudge this year. My mother loves it and it would be interesting to try to make, although there is a local store on the square that makes extraordinary fudge to which I may resort. There will also be the regular baking, whose ante is upped around the holidays: extra pies, scones, cheesecakes, not to mention the roasts and pot pies that happen around this time of year.
Later.

I just passed the thousandth indexing...

2005-10-08T12:58:00.000-07:00

...am at 1,004.
    Today is Optimum Range Buying Day so we're going to buy a range today, probably to be delivered on October 15th.
    Stats are caught up.
    Yes, I'm letting Mom sleep in. I'll be awakening her shortly. I need her on the phone and aware today.
    Later.

This month is my birthday month, you know. All month.

2005-10-08T00:26:00.000-07:00

I will be celebrating the end of my 54th year. I love this time of my life. I hope Mountain Dairy egg nog is being sold around my birthday.
We found another snapshot of Mom that she likes and wants published on the web, which I'll do later. I'll explain the circumstances when I publish it.

I've been doing grunt work...

2005-10-08T00:14:00.000-07:00

...on the website today, what little of the day I've been up. Mom arose late. I can't remember what time but I know it was after 1100. I arose first around 0645, realized my chance and dashed to the grocery for some staples. Although Mom and I had discussed going on a short shopping spree today I didn't see it happening primarily because I was feeling a little under this beautiful weather.
    Sometime after breakfast I laid down "for a half hour", chores not yet having been completed, meaning that my mother's bed, while having been sprayed with white vinegar and wiped down with alcohol, was not made. When I awoke at 1645 Mom was asleep on her plastic sheeted mattress, perfectly comfortable. I felt worse when I awoke than when I laid down, despite having taken two ibuprofen for the body aches I was having prior to napping.
    Things went well, though. Apparently Mom didn't have a problem with the idea of sleeping without bedding.
    I've got 23 dvds to enter. I alphabetized and catalogued the "new" ones today. I think that'll put us in at about 100 dvds, some of which I intend to trade out for others.
    I also tidied the navigation areas on many of the independent pages and attended to the Links sections of various partitions. I haven't used any of the reengineered search engines yet but expect to shortly when I flesh out the movie entries for the dvds.
    I haven't yet returned to indexing so I have topped 1,000 entries. That, I'm sure, will occur shortly, though.
    I've got stats but I may not enter them until tomorrow. I'm awaiting the finishing of the home made bread machine wheat bread. Fifteen minutes to go before I retire. Good time to clean-up.
    Later.

All searches are renovated, in place...

2005-10-07T10:37:00.002-07:00

...freshly indexed and ready to go. You'll notice that I've observed The Mom & Me Journals Dot Net partitions and set up separate searches for each partition. The right of each search page also functions as a mini-Table of Contents.
I'm a day behind on stats. I might get them in this morning. Mom was up until almost 0030 this morning, although in an up-and-down kind of way. She and I were both pretty inactive yesterday. I attacked the search engine problem with vigor and solved it.
I have not yet reached 1,000 individually indexed items for the Soon (relative term) To Appear Dynamic Table of Contents. I put that aside to restructure the search engines so that I could use them, if necessary, in compiling that index. As well:

I'm waaaay behind on cataloguing new movies. I'm not sure but I think we may have over a hundred DVDs now. I shudder to think how our collection will expand if Inside the Actors Studio ever sells their seasons on DVD.
I know, I know, I'm also waaaay behind on doing anything over at Caring. About Food.. Not a day goes by, lately, but what I don't think of something to record over there. Sometimes I post these thoughts at The Dailies, sometimes here, sometimes not at all.
I want to very much to finish all three of those apropos books I ordered. I've begun all three of them. I will be reporting back on those. I'm going to try to get free permission to quote from one of the books.

    I think we're going to be visited next week. I know we'll probably be making an appointment to see her PCP in Mesa on November 1st.
    This morning while I was out getting a few staples (like Half & Half for my coffee) it occurred to me that I might be having a website related "hot flash" of energy and focus in order to have a halfway decent birthday month this year but not neglect Mom. Mom, too, has been assertive about insisting when she's ready for movement.
    We need to purchase a new watch for Mom. The only watches she can successfully wear without magnetizing them are Timex® watches. Strange but true. Anyway, the band on her old one disintegrated a few days ago while going through the wash. The watch is fine but looks battered so we're going to scout out a replacement watch. Walmart has a large selection of Timex watches at a variety of price levels. Going there will involve a burst of intense walkering but I think she's up to it. Today would be a good day weather wise but we also need to do her hair so we may not get around to the trip until tomorrow. I know that doing her hair will involve some extended experimentation since I bought her some new hair ornaments.
    We might, with luck, be able to avoid a trip to Costco this weekend. I need to catch up with MCS and I have a side editing project going on which I'd like to be able to make some headway before Sunday. I continue to have the itch to index so I may be passing 1,000 within the next few days.
    You might, over the next few days, as I crawl between sites and change Link section navigators to the search engines, encounter a broken link or two. E me about them if you wish, that will help. In the meantime, I expect to get to all the broken links shortly.
    Later.

I've been caught in a snag of furious indexing.

2005-10-06T07:17:00.002-07:00

    I will probably reach the one thousandth entry sometime today. I've been spontaneously awakening at very odd hours; my favorite hours, actually: between 0300 and 0400. It's been nice but it's also required that I nap in the afternoon when Mom lays down. That's kind of a drag. I don't like to split my sleep.
    I cleaned up all the search portals and expect to be redoing those and setting up a "Search Index" [Good idea, I hope I remember it] with all search pages listed with a brief rundown of what each search partition searches. That index will turn out to be a definitive index for all independent pages throughout The Mom and Me Journals Dot Net compendium of sites.
    The Anal Retentive Table of Contents will probably be another month or two along. I decided to continue cataloguing until I am up-to-date. The process of rereading what I wrote remains fascinating. I've deleted a few technical posts where I was confused about how this journaling software time stamped a post. I'm doing a fair amount of editorial clean-up, mostly to do with syntax. I don't think anyone will be able to tell the difference. I've also transferred the spontaneous, infamous Love and All That Shit to the Essaying the Situation partition, where it is in correct time and date line. When I reread that post I realized that it stood alone as an extemporaneous essay.
    I will be entering Mom's stats for yesterday soon. I took them only once. She slept a lot. I kidded her that now that she's 88 she needs an extra day to recover from a blast of increased, vigorous movement. She looked at me as if to say, "88!?! You're kidding!"
    When she was up she was lively but she didn't spend enough time up and hydrating for me to worry about taking her stats more than once. She had only two meals: Breakfast, at the time about to be posted over at Mom's Daily Tests and Meds; and Dinner, which I'll review but without stats.
    As has become a habit again, I gave her a good foot and leg rubdown before she retired last night.
    Later, someplace else.

Where was I? Ahh, yes...

2005-10-04T22:45:00.002-07:00

...about her time warping the visit from the future to the past.
An Addendum to the above Referred Post:  This evening when she awoke from her nap she had a clear memory of the visit having happened "yesterday"; which is to say that she relaxed so well during her nap she reported to me, upon my query while she lingered at the edge of her bed, that she felt, "Great!" as though, "Never better!" was implied.
    Today's Mom's Daily Tests & Meds Dinner Stats report covers the evening in more detail. It was low key. She watched TV, I visited TV while I performed those morning and afternoon chores that fell by the wayside while company was here.
    Although Mom's monthly blood draw was accomplished on 9/26/05 I haven't gotten around to doing the BP report, glucose report or monthly review for the doctor. I know he knows from the results that she's doing very well and he doesn't need to worry about her. I intend to fax those reports in a day or so, the health review portion of which I'll record here.
    As far as I can recall, even with the presence of company, today was no more noteworthy than already noted here and elsewhere: A mellow, good day. Mom talked about going out to eat tomorrow. I think she vaguely remembers that our original plan was to take company out for lunch today. She's been looking forward to this. But with all the sleeping, both hers and mine, and the earlier-than-expected departure of our company ostensibly because of an impending storm but probably because Mom and I either remained asleep or feel asleep on them, the planned lunch-out didn't happen. Mom, now, feels she's owed a dinner out since the one thing she hasn't imagined is that the restaurant was experienced.
    I hope our company takes it as a compliment that we relaxed so completely in their presence.
    Goodness! Mom's still reading! Ah. Her light just went out. 2240. Good. Think I'll do some more indexing. Did I mention I'm in December of last year? I'm close to 1,000 index items, so far. Don't worry, I've got ideas about how to make a complex Table of Contents relatively simple.
    I might, over the next few days or maybe even weeks, be experimenting with CGI script features my domain host offers free. If they can be incorporated simply and easily into the format already established and attract some attention they'll stay. If not, they go.
    Later.

Mom is appears to be recovering from something.

2005-10-04T18:01:00.002-07:00

    Not incidentally, so am I. In one way or another she and I both slept through portions of our visit with friends. It would have been embarrassing if they weren't our informal family. Most of the tale of our day is told at today's breakfast entry at Mom's Daily Tests & Meds.
    Mom is napping, recovering from the little bit of the visit to which she attended awake.

    Flowers were offered, fresh home made bread was broken. Bonds were renewed.

    Last night something interesting happened that rent my heart a bit. As is my usual policy when we are retiring at the same time, I sent her in to brush her teeth, reminded her that I was going to brush mine in "my bathroom", told her to continue brushing her teeth until I returned to her bathroom. When I was halfway through the two minute timer on my toothbrush I heard her calling me, her voice high and frail, just this side of "shriek". She'd lost track of me halfway through her brushing routine, having been confused by the constant cleaning I did yesterday and the constant reminders of "company tomorrow", each reminder in which she delighted as though it was a fresh announcement of freshly made arrangements.
    I answered her immediately and she stuttered through her fear that I had "gone home with the company". Apparently I elaborated so well on who the company was by refreshing her memory of previous visits and her history with these people separate from mine that she experienced the visit before it happened!
    Ahhh, reconnaissance coughing. I'll be back...
    ...later...

No, nothings wrong...

2005-10-03T10:07:00.001-07:00

...everything is amazingly fine. I've been spending most of my "free" time working on the index. I'm only about 10 months away from the present. I'm caught up in the story and can't seem to pull myself away so I've been sacrificing report time to indexing time.
    I caught up on stats this morning. Catching up reminded me of a few things I want to mention. Mom's been walkering regularly and vigorously for the past few days. On Friday I insisted on a practice session on our driveway. The session seemed to bode ill for redevelopment of her walkering skills. After two laps her calves hurt and her knees became "iffy". I gave her a 200 mg ibuprofen (which I rarely administer) and she went to bed, moving almost not at all for the rest of the day.
    On Saturday, though, when I mentioned that I needed to make a "short trip" to Costco to replenish our egg and orange juice supply, much to my surprise she invited herself along.
    "Everything I need is going to be at the back end of the warehouse, Mom," I told her. "If you decide you don't want to do that much walkering I'll set you up for people watching at the lunch area at the front of the store."
    "Well," she said, "that's an option. I think I'll be okay, though."
    She was! She wandered from kiosk to kiosk eating a sample lunch. Insisted on covering all three aisles of Christmas stock. Remained standing through check-out; she usually insists on heading between the registers to sit at the lunch area while I check out. She enjoyed herself immensely and didn't complain about tiredness or pain (I continually checked with her on the state of her legs and back) until we arrived home and she swung around to get out of the car. Then, all she had to report was "a little stiffness." Wasn't interested in any pain medication, although she promptly napped.
    When she awoke yesterday morning she was excited and animated about our impending dinner engagement. As is usual during her bathing process, I asked her, "How are your knees? How's your back?"
    She answered, with a surprised look, "Fine. Why shouldn't they be?"
    I laughed. "You know, Mom, your body has amazing recuperative powers. After months of little to no movement you're back on the road, again. You walkered all over Costco yesterday. I just thought you might be feeling it today."
    "Goodness no! I'm fine."
    Okay, then. Never mind.
    What ever slowed her down for so long has apparently evaporated. I think I'll keep this mother.
    We haven't lately done anything in the way of formal exercising, although each day for about a week while she's sitting in her rocker I've been guiding her through some minor flexibility movements, even less than what I described in the last =>Moving =>Mom entry. Maybe doing these loosened up her internal energy pathways, although truthfully, these sessions have been so slight that I didn't think they'd matter, thus I didn't bother to report them. Her general stiffness hasn't seemed to be alleviated by them. Her hours have remained as usual, about half or a bit more of the day spent in sleep. Since Friday, though, she's walkered every day, a prodigious amount for her on Saturday and Sunday and hasn't needed oxygen when sitting.
    I'm thrilled. After dinner last night while MPS's family was walking us to our car MPBIL mentioned something about walkering around the house.
    "The walker's not handy in the house," I replied, "so we're going to get her a cane."
    "That's right," Mom chimed in, with absolutely no protest.
    Wow.
    So, we're having an active fall, this year. I'll take it. So, apparently, will Mom.
    Expect that reporting here will remain occasional until I'm through the entire index inventory. We have a few more visits coming up this month, too, one within the next few days. As well, as long as the woman wants to get out, I'll be taking her with me where ever I go, which involves more time than when she stays home. I keep the stats at Mom's Daily Tests and Meds pretty much up to date and usually include a few words about our day so if you're curious you might check over there.

It is with extreme pleasure that I announce...

2005-09-27T11:23:00.000-07:00

...the posting of yesterday's CBC results for Mom. She's looking very good on paper. No wonder she's recently had a surge in energy and her independence of spirit.
In case you're wondering why these test results have the ability to either exhilarate or trouble me, I remain never quite sure whether I'm doing the right thing by her, especially when I protect her from most doctors' ever itching hands. These tests results, even when they're not as good as today's, are the continuing validation I need.
I don't suppose I will ever be absolutely sure I'm "doing the right thing" by her. It's the nature of the current medical climate in this country to not only encourage but go to extreme lengths to "help" clients and advocates feel as though one's health and the health of one's charges is never in one's own hands and can never be so. Even the current "preventative" atmosphere encourages complete reliance on the medical-industrial complex rather than reliance on one's own sense of one's health and what one can or wants to do about it while using medicine as a resource rather than as a tyrant. It's impossible at this time to trust one's own sense of one's health unless one completely divorces oneself from this country's medical-industrial complex (usually done in disgust). In many cases, certainly in my mother's case, divorce isn't possible. However, the medical-industrial complex has not yet been able to erase all possibilities for self-validation of one's choices. Hurrah for this. May the situation only improve.

"You know, Mother would love this."

2005-09-27T08:43:00.001-07:00

    My mother said this between us listening to the 33th and 34th chapter of Genesis of the read-out-loud with accompanied DVD text version of the Christian KJV Bible last night. At least that's how I heard it while I was cuing the 34th chapter. "I know," I responded. "Too bad this wasn't available when she was alive."
    In my peripheral vision I saw Mom's head swivel sharply toward me, pause, then turn back to the TV. Oops, I realized, she'd said, "would" rather than "would've". She was thinking again that her mother was alive. I briefly imagined where the conversation might have gone if I hadn't restarted the DVD so quickly. It occurred to me that Mom may have said something along the lines of, "We should call her and invite her over for this in the evenings."
    Later, somewhere between two more chapters, she repeated her comment in a slightly different manner. This time I just said, "Yes, I know," and let it go. I figured no more discussion would be forthcoming or necessary since we were still deep into our separate understanding and images of the text being read.
    My maternal grandmother pursued life-long study of Christianity and its Bible right up the the time she was overtaken by severe dementia in her late 80's. Several of her ancestors, including her father, were Methodist ministers or otherwise involved professionally in Christianity. My mother, once she lived close enough, participated in some of the courses (both other and self-directed) with her mother. She also has an abiding interest in the intricacies of both Christianity and its sacred texts. So do I, although from a decidedly non-Christian perspective, which is why I love participating with my mother in our current pursuit of orally/visually guided exploration of the Christian Bible. Even before Mom mentioned her mother last night I suspected that she was thinking of her a lot as we listened and read each chapter. Last night proved me right.
    I think tonight as we indulge in the listening and discussion which has become an almost nightly habitual pleasure for both of us, when Mom mentions, which she surely will, that "Mother would love this," I'll say, "Mom, although she's passed on, consider that she is enjoying this with us. After all, there are no longer any geographical barriers to her being with you. Since we can't safely assume that there are any barriers separating her from us let's figure that she's here, continuing her study, reaping as much reward from this version as we are."
    This is, after all, the one way the dead remain with us of which we are sure: They remain alive and well and developing in our hearts and minds. Why not take advantage of this ability to commune with the spirits of our loved ones?
    We did not have an exercise session of any kind yesterday. Although Mom's nap was not inordinately long she was clearly overwhelmed by all the exercise in which she participated yesterday and loathe to move anymore so I didn't pursue it. I was just happy that she was so independently lively for so long yesterday morning and that, overall, her extra movement seemed to enspirit her.
    Blood test results should be up today. I've called once and they haven't yet arrived, so I'll probably be posting them later today. I'm not expecting any problems.

A post while I await...

2005-09-26T15:45:00.000-07:00

...the reheating of the water in the hot water tank in order to awaken Mom, bathe her and take her to the lab for this month's blood draw which will be just a CBC this time.
    Yesterday morning I awoke feeling somewhat less forlorn over my failures and quite a bit more optimistic about my ability to amend my ways. During the dressing part of Mom's bath, though, I enumerated for her what I consider my failures in motivating her, apologized with a few tears and vowed to do better. Independent woman that she is, she took the responsibility upon herself, telling me that my failures weren't my "fault".
    "Mom, they are. I'm not going to dwell on this, I'm just going to do better, but they are my fault. At 88, in your condition, you can't be expected to do more to motivate yourself than you already are, which is plenty. I'm sorry about the last year. I believe that my failure to stick to motivating you probably has caused you to be weaker now than you would have been had I not taken 'a vacation' and found all kinds of excuses for not keeping after you to move and exercise. But, I'm going to try to change my ways."
    She dismissed my confession, said that she felt this last year "was just fine, I did what I wanted to do, you couldn't have stopped me from that."
    Be that as it may, I of course continue my internal resolve to do better. I mention our conversation because, well, you'll see.
    My resolve, without effort, turned immediately into action yesterday. After feeding her and letting her food settle while doing a half-hour's worth of "morning" chores, without prior advertisement I gathered Mom's shoes, sunglasses and hat, directed her through putting them on, rolled her walker before her and said, "Mom, we're going to take a little walk in the driveway and survey the yard. I need you to help me decide what to trim before the seasonal yard garbage pick-up."
    She registered surprise and, thank the gods, enthusiasm.
    I told her I'd probably coach her a little to stay close to her walker and keep her head up. I reminded her the walker was not meant to be extra work but to make the work of walking easier. I reminded her how to "apply the brakes" on her particular walker model (which involves pushing down on the handles). She arose, walkered out the door, we negotiated the steps and were off.
    One lap of the driveway was all she could manage before she said, "I'm beginning to feel it in my knees."
    That was all I'd planned so we were in good shape. I'd expected that she'd stop several times while we took trimming inventory. Instead she kept on the move, slow and steady, commenting on various aspects of our wild, messy yard. She even noticed that the leaves of our indigenous tree have again this year succumbed to thrips, then noticed from across the street that the one on the edge of one of our neighbor's yards exhibited the same condition. I didn't realize she could see this well.
    What little coaching I did took place as she walkered up the gentle incline of our driveway from the street. I didn't drill or harass her. I just reminded her how to insure that her back took as little of the brunt of the walk as possible. She performed much better than I expected.
    When we returned to the house she commented that "the weather is beautiful this time of year", relaxed in her rocker and busied herself with watching TV and reading her new magazines. At around 1600, much later than I expected, she decided to take a nap. She was only down for about an hour, of her own accord.
    Again, after the very light lunch for which she opted and styling her hair, while she was scanning programs on TV, without comment I set up her exercise area in the living room and guided her to it.
    I rearranged the order of some of the exercises. We started with the stand-up/sit down, with which we usually end. After she stood the last time we did the belly grip, which usually falls in the middle of the session. I cut back on some of the reps but overall she performed much as she had the last time we exercised.
    During the session I studied her closely and began to wonder...toward the end I said, "Mom, do you think some of these exercises might be a little beyond your abilities now?"
    She seriously considered this and said, "Yes."
    "Let's try something a little different." From here on out we experimented with a short series of flexibility and balance exercises:

We did some chicken wing flaps with her arms bent at the elbow; first both arms together than alternate arms. She participated vigorously.
I brought her to her feet, had her hold onto my outstretched arms and we did a series of hip sways and weight shifting. She had no trouble keeping her balance and enjoyed the "hula" effect of the exercise.
I had her sit and directed her through slumping forward several times, breathing deep from her diaphragm and letting her back relax in that position, then sitting upright. While she was in one of the slumps she initiated a short, argumentative discussion about where the diaphragm was located. This clued me into the fact that her ability to breathe is good in a variety of positions. It didn't used to be.
I had her stand up once more and while she held onto my arms again we bounced just a little from the knees. She was surprised this didn't bother her knees. So was I.
After sitting I positioned myself at various spots around her body and directed her to push against me as I pushed against her. This is an exercise the FT taught me a year and a half ago to improve balance and confidence as it relates to body strength. She and I were both surprised at how hard she was able to push.

    Once we finished I said, "You know, Mom, I think maybe these are much better exercises for you than the ones we've been doing."
    "I think you've got something there," she said enthusiastically.
    "We'll still incorporate some of those others just to keep muscle group strength up, but I don't think we need to do all of them anymore and I don't think we need to approach them as though we're doing weight training for the Mrs. Ancient Pumped America contest."
    "Oh, I agree with you there," she said.
    "I think playing around and experimenting with balance and flexibility things is much better suited to who you are now."
    "I like these exercises."
    "You don't like those others, do you," I responded.
    She made a face. "Wellll, they were becoming awfully difficult."
    That settled it. I knew I was back on the right track.
    The most surprising development happened today. I'd already decided that she'd walker into and out of the lab. I told her this would be her "walkering exercise" today.
    All morning she and I talked about ways to incorporate ham into a variety of meals. She'd read a recipe some time ago for scalloped potatoes that included ham. Although she tends not to like potatoes she described this concoction, which incorporates onion and cheese as well as ham, with salivatory enthusiasm. Although she couldn't remember anything about the recipe except it's main ingredients I told her maybe I could figure it out from a standard recipe for scalloped potatoes.
    "Mmmmm..." she said, "how about tonight for dinner?"
    "Okay, but we'll have to stop at the grocery on the way back from the lab to pick up potatoes. You can stay in the car if you want and I'll dash in and get them."
    She agreed.
    When we arrived at the store, though, she announced, "I think I'd kind of like to go in and look around."
    Yeow! Can you believe it?!? "Okay," I said, trying to sound as though this was a normal occurrence. "It'll be a short trip, so I don't think you'll get tired."
    She gave me a what-is-your-problem look. "Of course I won't," she said.
    She was not at all interested in sitting at the deli area, which is her usual destination. Instead she wandered, discovering a "haunted house" the store had set up to promote Halloween candy. Then she prowled through the plant area.
    After I picked up potatoes and bananas I remembered that we'd need milk for the scalloped potato dish. "It's on the other side of the store, Mom. I'll tell you what. I'll dash over there and meet you in the middle of the store by the cash registers."
    That was fine with her. When I returned she was leaning against the barbequed chicken display admiring the plump, juicy offerings. We talked about the superiority of this store's chickens, one of which we had a couple of weeks ago. I assured her we'd have one again soon but tonight we had plans for scalloped potatoes with ham.
    "Oh, yes," she exclaimed. "We musn't forget those!"
    We went through the automated self check-out. As usual, she marveled at the procedure and said that the next time we come through she wanted to try it. I promised her she could.
    On our way out a couple of middle aged men winked at us. She beamed.
    She's napping, now. Her knees aren't bothering her and she's not stiff. I expect she'll probably put in a couple of hours. Her body isn't used to as much activity as it's gotten in the last twenty-four hours. I haven't decided if we'll do our exercise play tonight...I'll play that by ear.
    Although I know my mother is fundamentally wrong about her decision to take responsibility for her sedentary, lethargic year, I also realize, after today, that it is important to her to feel reponsible. This allowed my vow to get her moving to seep into her subconscious, I think, and allows her to become a cooperative participant rather than the object of my action. I didn't expect my vow to work itself out this way but I now see that this is the best way for it to work. Being Ancient does not delete the universally salutary effects of feeling that one's life belongs to oneself and is primarily reponsive to one's own decisions about how to live it, mistakes and all.
    Once we returned home I reminded her of the winking men and of the moments of humorous pleasure the lab tech took in a couple of little incidents at the lab which involved me saying some typical phrases to her that are a part of our "routine". "We make a good team, Mom," I concluded. "People notice us, take pleasure in us, are entertained by us, and we have a good time together mixing with the world."
    "You bet we do." She grinned.
    "So maybe we should take this show on the road more often," I said.
    "You bet. As often as possible."
    She's a year older now, a year further down The Road of the Ancients. While it's true that some Ancients still go to work in their 90's, some practice rigorous callisthenics daily, some spend a good hour Tai Chi-ing, and some are in nursing homes in fetal positions, my mother is my mother and she's forging her own path through Ancienthood, just like every other Ancient. My job is to keep track of her, assist when necessary or desirable, protect her from over-zealous medical people, keep the business of her life running smoothly and allow us to enjoy each other and the world. What a peach of a job!

    In almost miraculous response to my commiseration over my failures of the last year, yesterday I received a message from a reader who took care of both her parents. Understanding what I was going through, she reminded me that second-guessing is beside the point when caregiving, I "can only do what [I] can do"; that my mother is happy with me, thus bound to live longer for this reason alone; and what is important is to "keep communicating and interacting." I believe she is right. I'm grateful she was moved to remind me of these items.

    I did compile a review of our "normal" exercise session of yesterday which I'll be entering over at the =>Moving =>Mom section when I get a moment. I'll also be establishing links from there to here to incorporate the walkering sessions and the revision of our exercise sessions.
    As you can probably guess, posting this took a couple of separated sessions.
    Later. When I have another moment.
    Again, thank you.

I'm finally at the point in my review of everything I've written in these journals...

2005-09-25T01:18:00.001-07:00

...where I can say that I believe I failed Mom beginning sometime in October of last year. I know I was exhausted from our Summer of Health Problems, selling the house in Mesa and tending to a seriously ill cat who eventually died. I know that I desperately needed time to recuperate and felt as though I hadn't the energy to consider any other choice than to do it here at home by letting my monitoring and motivating of her slide. I know my recuperation not only took a long time but transformed itself into the habit of allowing Mom to have her way about not moving and not getting out, a habit in which I continued to indulge long past its necessity to my recuperation. Reading through all the stuff I wrote during and immediately after Mom's SNF stay (I'm up to the first few posts of August 23rd) and remembering what I allowed myself to do from October 5th, 2004, on in regards to letting Mom have her way because it was easier and less frustrating for me, well, I'm pretty sure I've failed her and allowed a steeper, faster decline than was necessary and possible.
    I know that The Wondrous FNP gave me reason, upon which I jumped as though it was a life raft in January of this year, to feel as though it was okay to let all the development that immediately followed Mom's SNF stay to revert. I know that up through today I've continued to use those excuses. The Wondrous FNP, of course, did not intend what I did with the information and advice she gave to me. She's not at fault. I am.
    Tonight I'm remembering back to my internal relaxation regarding letting Mom have her way, no longer fighting her and no longer fighting my desire to take the easier road with her, no matter to what it led. As I remember I'm thinking, damn, I didn't mean for this to happen. She is now homebound for all practical purposes (although Medicare would not consider her homebound). She rises and moves around but she's not confident on her feet so she spends most her time off them. On the occasion that I manage to get her to exercise and get out I haven't worked myself into the stamina needed to keep the exercises and the outings regular enough to encourage whatever strength of which she is capable.
    I can't help but feel that she isn't yet ready for the completely sedentary lifestyle she's leading. I know she disagrees with me on this. Lately, even before I began to consciously consider my failure with her, I've been initiating almost daily discussions with her, asking her in a voice edged with desperation if she is really satisfied with her life of little movement and even less physical confidence when she does move.
    She always says, "Yes."
    I ask her if she is really satisfied that she isn't getting out anymore. I remind her of the infrequent trips, maybe about every two weeks, when I'm able to get her out, I remind her that she seems to find these trips edifying.
    She says, she always says, "I go because you make me and I make the best of it."
    "But," I ask, "don't you prefer making a trip here and there with me?"
    She always hesitates, then says, "I'd prefer to stay at home."
    And the sleep. All the sleep. She's fine with this, too, even though I'm conflicted when I let her stay in bed or go back to bed, which she's been doing a lot lately, as you know.
    "Is it boredom, Mom? Think hard about this, because if it is, we can do something about that."
    She always takes a moment to think hard. "No." She always says, "No."
    I know she believes what she's saying. I watch her play Sorry for maybe 20 minutes then I watch her phase out. I watch her at the store or the lab surveying the novelty of her surroundings for maybe 10 minutes then I watch her phase out; I hear her saying, "It's about time we went home, don't you think?" I recall how all the visits we've had in the last year (which have been fewer than before but still some member of our formal or informal family has visited at least once every two months for at least a day, usually a couple) have barely piqued her interest and curiosity and have made no difference in her desire to sleep.
    I consider her lab results and think, "This shouldn't be happening. Her vitality should be higher. I wonder if..."
    ...I wonder if, I can't stop myself from thinking that if I'd been more stalwart, adamant, kept her moving, not stopped to take a vacation for myself to the point that I could no longer tolerate her intransigence in order to get her to move and go out, she'd be moving more, going out more and her vitality would be higher.
    I remember realizing sometime this summer that it appeared as though last summer was her last "warming up" summer and she wasn't going to be doing that anymore. I think that's my fault.
    She's okay, she's happy, she's satisfied, she even says so. I wonder, though, if, like a child who needs to be coaxed beyond her borders, I should have been coaxing Mom beyond her borders all this time but I gave in to my weakness, I gave up on her too soon.
    Then I remember, she's not a child, she's An Ancient One in the last years of her life. Her Chronic Renal Failure and Anemia Due to Chronic Disease are not going to reverse themselves. They are the harbingers of her last breath. Is her life playing out in the only way it can? Or am I encouraging a much faster, earlier end by allowing her to remain here, fairly immobile, rather than insisting that she move around and out?
    I'm going to try to do better without harassing her and yielding to my own sense of frustration. I hope I haven't contributed irreparably to her decline. If I have, of course I'll have to learn to live with this but I hope I haven't. I hope it's not too late. Or if, in fact, regardless of what I've done or primarily haven't done in the past year, the trajectory she's on would have been no different and my backing off has been the best and kindest caregiving I could have offered, well, I hope I come to realize this soon. One way or another my self-bedevilment needs to be resolved. I will be working on this resolution for the time being, trying to accomplish it with eyes wide open, focused both inward and outward, without fearful self-excusing and false self-justification.
    This time last year I was speaking out strongly about not giving up on Ancient Ones just because they're Ancient. I feel as though I might have given up on my mother because it was convenient for me. If I've been doing this I want to face this squarely and amend my ways. If I haven't I want to face this squarely and continue to love her, remain with her and allow her to continue her life as she desires without wondering if I should be doing something different and without unnecessarily confusing and frustrating her.
    Help me. Thank you.

Night and Morning.

2005-09-21T11:58:00.000-07:00

    This morning a Treasured Prescott Friend mentioned that another friend, whose mother is in her 90's and living in an assisted living facility, had an experience so disconcerting that she needed to discuss it with her friends. She visits her mother so frequently as to be considered a daily presence in her mother's life. Some days ago she engaged her mother in an animated, hour long conversation about mutual relatives, friends and concerns. As she was leaving her mother expressed her gratitude for the visit and asked, "...and what was your name, again, dear?"
    I couldn't help but muse out loud with my friend about this, since she and I were discussing types and levels of dementia in the elderly. She and I compared notes about my and her mother's dementia (her mother died some years ago after living with her and her husband). We talked about how both our mothers have mistaken us for contemporaries, sometimes older friends or relatives, sometimes, well, we're not sure who we are/were to our mothers. I mentioned that although I'm often not sure what relationship my mother thinks I am to her, I'm always "Gail" and I sense that my parameters in her life are settled, even though I may be "Gail" the daughter, the roommate, a cousin or a friend; once (and only once, so far) I was her mother. It occurred to me as we talked that maybe with the Ancient Demented, familiarity breeds more familiarity. I suggested, while assuring my friend that I was in no way criticizing the arrangements under which our other friend's mother lives, that in order not to be the "...and who are you, dear?" person in a beloved Ancient One's life one has to be with the Ancient One when she retires at night and awakens in the morning. The more I contemplate this the more convinced I am that this is probably the only reason my mother never asks who I am.
    By way of explanation: At this stage of my mother's life her night dreams are so vivid and memory-filled that when she awakens it is as though her entire being has been transported to the area and among the people highlighted in her dreams. She's never been disoriented when awakening from the sleep that fosters these dreams but I've often and briefly considered that this period is partially responsible for her episodic belief that we live in Iowa or South Dakota and are geographically situated close to the doorsteps of a variety of her living and dead relatives. I think this is why she is more apt to believe, immediately after awakening from either deep or light sleep, that many of her dead relatives are alive and coming to visit or available to be visited. This morning during the conversation with my friend I realized that I am always at her bedside before and after her dream travels, bidding her good night or good morning, receptive to the news of her dreams and, by default, a reminder that she remains in reality (whatever reality she's traversing) as a member of a family of which I am the ever present representative.
    My friend also advanced another provocative outlook. She said that although her mother's demented behavior was much like my mother's, she never really considered that her mother had "dementia". I think this is a healthy, productive attitude when dealing with Ancient Ones whose mentality has turned creative. I think it is this consideration which causes me to label my mother's dementia "creative mentality". While it is true that lately I've been using the word "dementia" and its forms more often, I've been doing this to a purpose: My intention is to destigmatize the word and change what it implies. Too often, I think, we forget that dementia has many forms and isn't always apparent within those who may exhibit an episode of forgetfulness here and there, nor is it always progressive. Because of the popularization of advanced Alzheimer's dementia we freak when we hear the word and imagine only a frighteningly progressive and debilitative state that we believe spells certain mental and physical doom for anyone who forgets anything if they are of or beyond "a certain age". I can report with confidence that dementia in the elderly is as varied and unpredictable as the variety of plants that may or may not push themselves above the soil line after every seasonal monsoon soaks the wild part of our back yard. From summer to summer I can be heard to exclaim, "Wow, I didn't know we had this in our yard," or, "Oh, cool, this is back, I thought it had died out last year!"
    The human brain is an amazing organ and becomes even more amazing as it ages. It is not only the keeper but the creator of our reality and deserves to be respected as such. I think it would do us well to spend more time attentively listening to the productions of Ancient brains to discover what they are revealing about the individual brain keeper, reality and the state of being human, thus spending less time fearfully labeling these productions and imagining horrors we believe are implicit in the development of mentally creative constructions. I think the key to this attitude is to consider that Ancient brains don't shrivel reality, they expand upon it. Sometimes this can be frightening and depressing for both the Ancient One and the observer, especially if the Ancient One retains one foot in our species' agreed upon social reality. I refuse to believe, though, that fright and depression are necessary reactions to Ancient dementia. I think that the proper attitude toward such flights is marvel. I'm not suggesting that we stop trying to figure out how to keep our loved ones with us in our agreed upon reality as firmly and as long as possible. What I am saying is that at this time much of the dementia of Ancient Ones is inevitable and irreversible. We are a species that has evolved socially and craftily enough to allow these flights and foster the safety of those who soar into Mental Fancy. We do our species a disservice when we shrink from this atmosphere and those who take to its skies.

Soon after that last post, yesterday...

2005-09-20T19:02:00.000-07:00

...the day was lost to frustration and depression for me. It started soon after she awoke, while I was trying to get her "up" for taking an errand trip with me to the grocery store. she was "joking" about how it wasn't necessary, she's seen the store, blah, blah, blah. Then, as she was moving off the bed, she faltered a bit. I came to her aid but, I don't know, something about the incident set me off. I castigated her thus [paraphrased from memory]: "You know what? You shouldn't joke your way out of outings. This faltering? It's because you're refusing to move. Because it is so exhausting for me to try to get you to do exercises that I only do it, anymore, when I'm in a really, really good mood. It takes so much of my energy to get you to move that it regularly exhausts me. It exhausts me just to try to get you out of bed in the morning. It exhausts me to try to keep you up at least 10 hours a day and, lately, I've been giving up so much that your up part of the day has dwindled to 8 hours, if that. And now you're faltering. And, overtly, I'm at fault because I can't motivate you to move, but you're at fault because you continue to think you don't need to continue to move. Listen, Mom. You are, officially, now, a danger to yourself whenever you move. You stand up and you're a danger to yourself. You take a step and you're a danger to yourself. Why the hell do you think I make sure I've got my nose up your ass whenever you're up?!?
    "And, you know what, I've had it. I'm taking a vacation today. You don't want to move? Don't move. You want to sleep yet another day away? Have at it. All I'm saying is, if you continue this happy-idiot (yes, I used that phrase) lethargy, thinking that it doesn't take movement to keep moving safely, you're not far away from not being able to move at all."
    From that point on I was stony silent for the rest of the day. It wasn't fun for either of us. I got lots of errands in during her nap, though, because she slept like a log.
    I still had some of that frustration and exhaustion left over this morning and barked at her a little but it's been fading for the last few hours. This morning before she awoke I did a lot of deep thinking about why I seem to be more suseptible to these moods during this time of year and realized something that I wish I'd realized long before: Fall and winter are my favorite times of year. They are known to be not only my most productive but my most social (which is saying something, considering that I'm not terribly social anyway). This has been true for decades. I have, too, for decades, associated the internal rush of energy and inspiration and amiability that typically floods into my life at this time with these seasons and look forward to it. Last year and this year, though, I've been laboring under the conditions that are required by intense caregiving. Without observing what had been going on, I've allowed these conditions to adversely affect my usual fall/winter internal ambiance. When I figured this out this morning I could feel myself relax. I doubt that I'll be able to alleviate the conditions but I seem to have inherited the same operational system that often influences my mother to change when necessary: Become aware of the need for change and change begins to happen, often without conscious effort. I can't predict how I will modulate myself in order to remain an effective caregiver and allow myself to enjoy my Dark Season Surge. I now know, though, that I will and I'm looking forward to the process, however subconscious it is.
    I had to explain to my mother this afternoon why it is that although I spend a lot of time trying to agitate her into movement I also sometimes refuse movement to her in which she offers and/or wants to indulge. The situation: I asked my mother if she wanted some coffee.
    She confirmed that she did then said, waving me away with her hand, "I'll get it."
    "No, Mom, I'll get it for you."
    "But you always want me to move, then you don't let me move!"
    I know this is what it looks like to her. "Mom, if you want to go into the kitchen with me while I make your coffee you can. I've invited you to move around the house with me any number of times. Is that what you want?"
    "Doesn't seem necessary if you won't let me make my own coffee."
    I sighed and reseated myself on the couch. "Mom, let me explain to you why you no longer make you're coffee."
    "Good," she said, stern as the school teacher she's been. "I'd like to know that."
    "A couple of years ago you started exhibiting a few behaviors when making your coffee that caused problems, sometimes dangerous problems. First, you could no longer remember that some of our cups shouldn't be used in the microwave either because they had metal decoration [gold and silver] or they became hot in the microwave. You burned yourself hands more than once, dropped cups and broke them, and sparked the microwave. Second, you could no longer remember the difference between one minute and ten minutes on the microwave. Third, you could no longer remember to remove the spoon you used to stir your coffee into the water from the cup when you used the microwave. Fourth, you decided that you could sprinkle coffee from the jar into your cup instead of spoon it and often ended up using a good quarter of a jar in one cup, didn't realize this and went ahead and made the coffee that you refused to drink. Fifth, when I instituted using the electric water pot you couldn't hear the water whistling and we went through a couple of pots very quickly because you burned them out. You also burned out one of our microwaves with spoons in cups."
    By this time Mom was shaking her head in shock as though I was describing someone else's behavior.
    "So, Mom, that's why you don't make your own coffee anymore. Some of these reasons are also reasons why I won't let you cook anymore. Are you suffering because I won't let you do these things?"
    "No, no. I never liked to cook anyway. But I would like to be able to make my own coffee. I'd have to move to do that."
    "You can move when I do it, Mom. I'm not stopping you from going into the kitchen with me. It's common for me to invite you in there. Do you want to go and watch me make your coffee now?"
    She waved away the suggestion. "Doesn't seem necessary."

    My difficult thirty six hours have also caused me to consider that perhaps we're entering another period in which my mother will noticeably slow, perhaps even lose a significant amount of the little physical strength she still has. I'm definitely going to get a prescription for a cane when we go to the doctor in late October/early November. Maybe I can head off some of that strength loss at the pass if she feels more confident moving around here. Then again...

Mom seems to be getting into the habit...

2005-09-19T10:27:00.001-07:00

...of retiring then arising again an hour or so later and staying up for a good hour or so. It's homey and nice. These periods are shared quiet time for us: She drinks a cup of coffee, I drink a cup of tea; she sits in her rocker and reads her magazines, I work on cataloguing more past journal entries; we discuss items of interest that we encounter; if I've forgotten to rub down her legs I do this, as I did last night; we talk about possibilities for the following day, then she retires.
I've been meaning to comment on entries in arrears as I continue cataloguing, but I can't seem to pull myself away from the momentum of following our past days, one major episode to another. My intention is, now, to continue cataloguing until I'm caught up on this journal, then construct the Table of Contents. I'm making notes on things upon which I want to comment such as:

The build-up to her blood transfusion;
The build-up to her low sodium episode, which I'm now cataloguing (I'm in mid July of 2004);
How circumstances are generally different than now and how they're surprising similar. Not that I'm expecting plunges in her present good, steady health but I'm astounded that, overall, except for blips here and there, her health and activity profile has remained the same over the last couple of years; this gives me a shot of confidence. I think the only aspect that has changed is my aspect: I've clearly become much more relaxed about her inactivity, even though I continue to harbor some minor anxiety about her muscles weakening.

    I'm not sure what we'll try to initiate, today. Maybe some exercises; I need to go to at least one grocery and as of late last night (she retired for the final time a little after 0100) Mom thought she might want to go, too.
    I've received all the books I mentioned ordering in a previous post. I've skimmed them, although I don't imagine I'll get around to reading them until I've finished cataloguing. I read something interesting and relieving in the Sick to Death book about how the profile of chronic disease due to organ failure in the elderly closely follows the pattern Mom is following: Extended periods of good to excellent functioning of the organ(s) in question followed by a usually sudden and fatal health crisis. Interesting. My intention is to seek permission from the authors of these books to quote passages I think are important. I'll report on how the permission seeking process goes.
    I just noticed that the url to my picture of Mom isn't translating now that the post is archived. Guess I'd better fix that.
    Later.

Nothing unusual about yesterday...

2005-09-18T08:53:00.002-07:00

...except that, at my mother's request, after breakfast I stopped taking stats for the day. The circumstances are recorded over at today's post for Mom's Daily Tests and Meds. If everything seems okay today when I awaken her (planned at 1100) I'll probably not take stats today, either. Although I assume that stress does not affect her blood sugar, I know it affects her blood pressure and I'll bet if I manage to keep myself from fastening that damned wrist cuff on her today her blood pressure will remain in the two 2.5 mg lisinopril range all day.
    We have another plan, a trip to a grocery for some essentials. I'm hoping she'll accompany me but I'm not going to push. As usual, she expressed enthusiasm yesterday but may not today.

    I've got a bug up my ass that I want to mention before I continue cataloguing for the Table of Contents. Yesterday I was leafing through old magazines and pamphlets in an attempt to reduce some of our constant clutter and throw away those I know we'll not again access. I wish I could remember in which particular magazine/tabloid/newsletter I saw the following (which is a paraphrase from memory): "Don't feel guilty if you aren't in a position to provide care for your parents during their later years. There are plenty of fine services out there ready to provide adequate care to your elderly parents. Use them. Not only are they better prepared to handle the job, your time with your elderly parents will be freed to enjoy their company without irritation."
    On first reading I dismissed it with a curt, vaguely critical, "Yeah, right." This isn't the first time I've read something along these lines. After I'd dumped the lot at the recycling bin a mile down the street certain trigger phrases continued to wander, in black-on-white serif type, across my internal line of vision: "plenty of fine services"; "better prepared to handle the job"; "time...will be freed to enjoy"; "without irritation"; and, the ultimate trigger phrase, "Don't feel guilty".
    I've fallen into that "don't feel guilty" trap a number of times in my life. Until recently I've not questioned Maya Angelou's observation, popularized by Oprah Winfrey, that, "...if you'd known better, you'd've done better...". Yesterday, though, my niggling, usually dismissed doubts about this advice were finally caught in the "headlights" (thank you Alan Watts) that are my conscious attention. I think, at least in this nation, we need to popularize feelings of guilt: For our miserable record as caregivers to not only the elderly but to children; for our willingness to believe that "they'll understand," either when "they" are older or "they" are dead; for our refusal to acknowledge that, no, professional care in this country for the elderly is not "fine", in fact it's barely available at an "adequate" level; for thinking that "adequate" is "okay"; for not acknowledging that guilt is usually triggered when we have, indeed, known better but haven't acted out of higher motives; for thoughtlessly heaping feelings of guilt on our already overburdened caregivers who often aren't, themselves, the guilty party but are frantically trying to make amends for the guilty parties who are assuaging themselves with such phrases as, "don't feel guilty, if you'd known better you'd've done better, one of these days they'll understand".
    And what about the decision not to care for or visit the Ancient and Infirm unless you're sure the experience will be pleasant [initial discussion here]? This was the underlying reason for a family putting their matriarch in a nursing home for her final days, as cited by a fairly recent article in NYT entitled Will We Ever Arrive at the Good Death? in which the family was quoted as saying that in a residential hospice they could "just focus on loving her" without the hassle of trying to take care of her. Something I've learned about love since taking care of my mother: It is impossible to experience informed love, which is the deepest kind of love, without caring for someone when their chips are down. While I peripherally sympathize with the busy families of modern society finding the possibility of caring for an intense needs individual more than they can imagine bearing and fearing that this will somehow adversely affect their ability to love that individual, my experience of caring for my mother, as well as my lack of experience and, for that matter, awareness in caring for my father when he was ill-to-death, informs me that, of the two experiences, being my mother's caregiver, especially during the intense, messy, hellacious times, is directly responsible for my unusually expanded ability to love her and the rewards of such a love. In the face of this personal development I even, sometimes, wish I had been more available to my father as he wilted and my mother struggled to take care of him. Although he and I are at peace with one another and were at the time of his death, I can't help but continue to wonder what I would have discovered about him and how much more informed, therefore inclusive, my love for him would have become had I made myself available to him on his very difficult (both for him and my mother as his caregiver) final journey.
    I believe that every society's first conscious priority should be caregiving. I believe that caregiving is best done within a group of individuals (whether family or community) with close ties to one another that has the blessing and the full emotional and survival support of the society within which that group functions. I believe that when a society demeans caregiving by assigning it to one unsupported, undervalued, overburdened sub-group within that society the entire society is at risk for exactly the diseases of the soul from which U.S. society suffers: The inability to embrace life at all its stages; the inability to consider caregiving the fundament of everything we do as humans; the inability to understand, practice and support the detail and the gifts of superior caregiving; the inability to recognize that "individual responsibility" and "individual initiative" in a species as relentlessly and dependently social as ours are oxymorons.
    I believe it is time for all individuals in our society to acknowledge guilt, feel guilt, then respond to our higher social motives and do something, besides concocting feel-good Madison Avenue propaganda, to truly assuage the caregiver guilt to which we are all subject. Each of us already knows better. It's time for us to do better.

A detailed report...

2005-09-16T19:30:00.001-07:00

...on Mom's day today and my feelings about this recent Lethargic Episode is over at Mom's Daily Tests and Meds. The link will take you directly to it. On that issue I have no more to say at the moment other than what is over there.
    I just finished cataloguing the particular partition of The Mom and Me Journals through Mom's early, startling recovery from her blood tranfusion in early June, 2004. Again, I'm glad I've decided to catalogue all this writing for somewhat easier access. I was gripped by the build-up to her transfusion, the transfusion itself and her recovery from her flirting with grave iron deficiency anemia. I learned a lot from rereading it. I'm so glad I record in detail in these journals. Her journey into grave iron deficiency anemia, I can see, started long before her dangerously low hemoglobin was discovered. All the symptoms I was researching, all the amateur diagnosing I was doing never led me to this conclusion. I'm somewhat better informed now, of course, but that isn't saying much. What, for instance, is the cause of this recent Lethargic Episode? I haven't the faintest idea. I think I'd be able to recognize another dangerous dip in her hemoglobin and I don't think that's happening now, primarily because there is no vomiting, no radical fluid retention and no surprisingly low blood pressure. I don't know, though. As I mention in today's Breakfast Stat post, I'm glad we've got a blood draw coming up soon.
    Maybe it's just old age. It's hard to tell with her. I realized how hard this is when I reread the section about her demeanor in the ER at the hospital the night that her dangerously low hemoglobin was discovered: She was animated, to be diplomatic. I don't know, yet, if I wrote about this but I'm going to here: I remember that during diagnosis and prep in the ER behind the curtain she continually tried to get off the gurney to the point that restraints had to be threatened to keep her on it, insisted she wanted to go home and that she was, under no circumstances, going to assent to a transfusion. One of the ER nurses mentioned, before a blood test was done to confirm her dangerously low hemoglobin, that the previous test that had sent us to the ER room was probably wrong because, normally, someone with hemoglobin that low would be unconscious or close to it.
    I invoked my MPOA and overrruled my mother's desire to leave without a transfusion. I did it gently, considering the circumstances. In front of one of the doctors who was fast becoming exasperated with her I remember telling her that, "...this time, Mom, you're wrong. This time you need to trust me to make this decision, even though it's not the decision you'd make. I've done the footwork, I've gone over your entire history of blood draws, the doctors are right. You need this transfusion and I'm not going to let you refuse it." I'm paraphrasing, of course.
    She settled down.
    I clearly recall the surprise of all her feisty, determined, crazy, oppositional energy after days, weeks really, of extremely low energy. Such a woman. Such a woman. I wonder what she has up her sleeve this time.
    Hmmm. Maybe I'd better go back and read the link I published when I thought, previous to the blood transfusion, that she might be experiencing acute mitral valve leakage. She's probably not now but it wouldn't hurt to review that just in case.
    She's been down for almost three hours. Despite me agreeing to a "sleep day" I think it's time to get her up and moving if for no other reason than to feed her, pill her and remind her that I'm here: Her family awaits.

Over the weekend...

2005-09-14T23:48:00.001-07:00

...we had a couple of really windy days which swept the last vestiges of summer out of the mountains. The nights are bordering on cold, now, the days are cool and bright and I'm making bread again, every day to every other day. I found a store that sells high altitude flour and what a wonderful invention that is! I'm not having any flops. In the spring I was having such trouble with figuring yeast usage on a day to day basis that a little over every other loaf was either too well yeasted or didn't have enough. We ate them anyway and they were good, but the texture and the tops left a lot to be desired. This flour makes for a much more pungent smell when the baking cycle on the bread machine starts, too. Both Mom and I are reveling in the smell. We were experiencing a loaf back-up so on Monday I didn't make bread and in the afternoon Mom complained about the lack of the aroma of bread baking.
Speaking of which, we've begun our Christmas baking list. Mom's famous fruitcakes are on it. I'm going to attempt our own Panettone this year, too, in the bread machine, of course. As well, we're planning on old fashioned ginger snaps, Mexican Wedding Cake cookies, the old original Hudson Date Bars (totally different than the one's you're probably used to with the date mixture between oat crumb layers), my original German Chocolate Cake cookies, the perfected Honey Bear Brownies, of course, and we're looking for a really spectacular chocolate cookie, something different from the usual. I'll probably be pulling out my maternal grandmother's cookbooks and notes to see what I can find there, too. We haven't done Christmas baking for more than a few years. If you're suspicious about why I'm making sure we do Christmas baking this year, you've probably guessed the reason: It's one of my mother's favorite things to do during the year and I'm thinking we don't have too many more years to incorporate it before she won't be here, anymore. I just want to make sure that she slip slides away in the midst of doing some of her favorite things.
My fascination with my writing in these journals continues to hold up the actual creation of the dynamic Table of Contents. The database I'm setting up is divided into categories underwhich I'm cataloguing anchored snippets that pertain to the categories. I hadn't expected that I would find so much to catalog. I thought I'd repeated myself a lot in these journals and probably said a lot that wouldn't need to be catalogued. I'm find the opposite, though. In case you're curious, here are the categories underwhich I'm currently cataloguing journal entries and snippets of journal entries:

Anemia
Assistance Devices
Bad Days
Bowels Away
Caregiving and Relationship Issues
Caregiving and Spirituality
Dementia
Family Dynamics and History
Food
General Health and Medical Issues
Giving Up Things
Home Doctoring
Housing and Ancient Ones
Hydration
Inactivity
Incontinence
Leaving Mom Alone
Medical and Healing Treatments, Procedures and Diagnostics
Medical Professionals and Us
Mom Mourning
Mom's Attitude and Stamina
Mom's Changing Preferences
My Commitment to My Mother
Old Age Diabetes
Pertinent Descriptions of My Mother
Protecting and Surrendering
Purpose of Journals
Sleepy Time Gal
Taking Over Business Affairs
The Caregiving Situation
The Detail of What I Do
The Literature
The Smell of Caregiving
What Old Is
When Other's Notice Caregiving
When Others Notice My Mother

.    Hold on. I'm going to publish this so I can see how many categories I've got. I've not yet counted them.
    Shit! 36! I was figuring maybe 25. My guess is that by the time I'm done with the initial cataloguing I may have added a few more categories.
    Some of the categories contain entries as straightforward as the titles underwhich they're organized. Some of them cover a variety of sins. The "Leaving Mom Alone" category, for instance, not only contains posting about, well, leaving Mom physically alone but also contains stuff about not pestering her about stuff that doesn't matter anymore. "The Caregiving Situation", which is one of the largest categories, contains a variety of material organized around postings that describe what it is like to be a caregiver and ruminations about caregiving in general. You'd think that "The Detail of What I Do" would contain essentially the same type of material as "The Caregiving Situation", but it is far more specific.
    I will be including yet another separate category listing the essays and various other stand-alone pages and journals such as the Test Index and the Movies, Mom & Me journal.
    Anyway, as I read I'm doing a bit more editing than I intended so my material reads more smoothly. I'm not taking out my stylistic peculiarities but as I read I notice and correct flubs that make reading difficult for me. I'm deleting excess commas, as well. I'm also trying to standardize items like how I publish links to movies, web sites I mention, places within this set of journals, etc.
    Well, I think I'll catalogue another archived section then head for bed.
    Later.