Wednesday, August 28, 2013

..."That's what I'm here for"



“Can you come here for a minute?” Miss Cathy called out the familiar refrain.

I’ve heard that phrase as a preface to many a request in the last three years.

“Can you help me hook my bra, I can’t seem to get it on.” (Which usually means it was on backwards, inside out or both and is followed with a litany of expletives of how much she’s always hated being ‘busty’)

“What day is it?” (She asks this almost daily now, which is understandable for someone (anyone really) who doesn’t have a job, deadlines or have to rely on a schedule or clock any longer. But what I find troubling is that there are days when it’s after dark and she can’t distinguish whether it’s day or night)

“How much is four times twenty?” (This usually happens when she’s trying to count money)

“I can’t find a can of soup in the pantry, can you look and see if we have any.” (The pantry is stocked full of canned, paper and other goods that she can never seem to ‘find’)

“This TV is messed up again, I can’t get it to work right.” (This usually means that she’s pushed the wrong button or any number of random buttons on the remote causing the TV to either shut off, switch to DVD, Video mode or have to reboot itself after so much activity)

“Did I take my medicine? Is it time for me to take my medicine?” (Since I’m in charge of dispensing her meds I can usually remember if she has and if not, looking at the weekly pill dispenser easily solves the problem)

“Can you dial (insert the relative or friend’s name here) for me?” (Unfortunately she lost the ability to remember telephone numbers she’s known by heart for decades along with the loss of her short-term memory)

And so on and so forth, that’s just a sampling of what she asks and what she needs, not all at the same time and not everyday (Thank God) but so goes the dialogue and familiar ways and days of living with Miss Cathy.

“Can you come here for a minute?” she’ll ask.

“Of course”, I reply, “that’s what I’m here for.”

Monday, August 26, 2013

Another day, another Doctor: Pt. Vl


"That other doctor didn’t know what he was talking about”, Miss Cathy said, after Dr G decided to reject the suggestion of adding a statin to her daily medications.

“He was just generalizing, he didn’t know me.”

“Well, yes he did”, I piped in, not so much in support of the vascular surgeon she just saw so much as defending doctors in general.

I sat there feeling as if I was under attack for (“heaven for fend”) not only suggesting but also encouraging her to go the doctors and specialists we’d seen in the past several weeks and months-regardless of the outcome of their findings.

Believe me, I understood her frustration after schlepping to more than six doctors in a two week period with no hard diagnosis but what she couldn’t (or wouldn’t) appreciate was the fact that answers are not always guaranteed when you have questions for a doctor.

Sometimes they just ‘don’t know’ and the best they can advise is to monitor the situation or seek a second (or third) opinion.

“In Dr M’s defense”, I continued, ”He was just making a recommendation. He did say that the final determination would be up to Dr G so I wouldn’t just dismiss him. He was looking out for your best interest.”

“Yeah, well….”, she said dismissively, “I can understand that too but I don’t want to take anymore of that medication.”

“All dem pills!” began her familiar retort, followed by, “I don’t see why I have to take’m.”

And so the broken record continued…..

“I’m gonna die anyway, like everybody.” “Nobody is going to live forever.”

Apparently the good doctor and I were to be subjected to all her greatest hits.

Before my ears started to bleed I said, “Then stop taking all of them, don’t come to the doctor and you’ll be dead that much quicker.” 

“Will that make you happy?” I asked, not quite rhetorically but not expecting an answer either.

“No, not all of it” she said thoughtfully, “I’ll take some of it, but not everything.”

“Well, actually, that’s the problem, you see, we’re here so the doctor can make the ‘call’ on the medications, it shouldn’t be up to you to decide what you take and don’t take.”

“What’s the point of having doctors if you’re not going to listen to them?”

My question evaporating into the sterile, antiseptic air in the examination room as Dr G closed his notepad, having already said that he wasn’t going to make any change in mom’s meds (or get in the middle of our “George and Martha” act) then got up to leave while Miss Cathy looked around, not for an answer but for her purse and cane before wobbling off to the phlebotomist.

And so ended the appointment, just “another day, another doctor”.



TyTip: Carry your own version of a “Cathy Clutch” (a tote bag filled with all of your loved one’s doctor’s files, paperwork, a notebook and pen for taking notes and film from any/all exams or tests, plus their identification, medical and insurance cards) to all of your doctor’s appointments, you’ll never know when you’ll need something!

TyTip too: Type up and print out a list of your loved one’s medications (be sure to include the dosage(s), what the medication are used for and what condition they are to treat) as well as medicines they might be allergic too

Your “Medications List” can be attached to medical forms and can also be handed directly to doctors and nurses who may inquire about your loved’ ones medications as well.

Having this document will save you a ton of time! Don’t forget to update your list whenever there is a change (addition or removal) of a medication or change in dosage

Friday, August 23, 2013

Another day,another Doctor: Pt. V


“Yeah”, Miss Cathy said, agreeing with me as if I’d been serious when I’d said, “From your lips to God’s ear", this in response to her saying that “I could die before her”.

”Nobody’s time is guaranteed in this life you know.”

She continued as if we were really having a conversation about mortality instead of verbally sparring with each other.

The fact that I’d just ‘wished’ an early death on myself to get away from her completely going over her head.

“You don’t have to be a certain age to die.” She said, quite please with herself, looking to the doctor for a visual ‘high five’ as if she’d just ‘nailed it’ with her observation.

Dr G was sitting between the two of us, poor man (Switzerland between France and Germany) awkwardly trying to find some neutral place to gaze upon.

“Oh my God!”, was all I could think. “Shoot me, shoot me now!”

“Mother” I interrupted her before she could continue gloating about the possibility of my early demise.

“I was being facetious.”

“You know what” Dr G said, having found a safe spot near the door to focus on, “I’m not getting in the middle of this one.”

Miss Cathy shrugged and changed the subject.

“How is my cholesterol count?” She queried, showing no signs that she’d forgotten the other subject at hand, which was whether or not to add a statin to her daily medications (which total 12 pills at last count…..8 in the morning and 4 at night).

“All medications have side effects you know.”

Dr G opened up what is turning into a volume of notes worthy of a JK Rowling’s novel and after a careful review said, “Last time we checked it wasn’t that bad at 218, which isn’t too bad, but the LDL was 107 which is spectacularly good…so on second thought I’m going to say ‘No’ to the Lipitor.”

“Her protected cholesterol is really so good that I don’t want to do it.” He said to me.

"Yes", Miss Cathy said, as if she was being vindicated that she was right all along (when actually she wasn’t right so much as just argumentative and stubborn).

Wednesday, August 21, 2013

Another day, another Doctor: Pt. lV


Squeezed onto a faux banquette that must have been intended for a toddler, I tried my best to sit quietly in the corner and not listen to Miss Cathy and Dr G debate the merits and side effects of statins, focusing instead on my ‘happy place’ (which at the moment was anywhere but there).

As part of my (self assigned) duties as ‘caregiver’ I’ve trained myself to be as unobtrusive as a butler (or how I’ve perceived one to be), fading into the background after I’ve chauffeured her to the appointed destination but available if need be.

I do this so that Miss Cathy can feel free to have whatever exchange she wants with whomever she’s meeting with, without a care or thought as to what I may think (and believe me, this works just fine for someone as self righteous and self absorbed as she is….she could give ‘two hoots’ what I think or how she’s being perceived…..I’m just saying).

I will say though, it’s hard to listen to the same questions and answers over and over.

But, they are her doctors; her meetings and appointments so the focus should be on her, I’m just the ‘transporter’.

And this works out just fine for the most part; at least it does on the days when she’s lucid, heaven help us all on the “off Alz days”.
 
I try, let me emphasize the word ‘try’; meaning I make and attempt or effort to do something (like keep my mouth shut), so my objective is to ‘try’ not to interject during Miss Cathy’s exchanges unless she’s misspoken or given the wrong answer to a question (and I do not hesitate to jump in when her health is at stake).

It’s my (self assigned job) to give factual answers and to fill in the background for whatever the doctor may have asked, hopefully without any sarcasm or added editorializing on my part.

But, it’s not easy to sit idly by when (I know) she’s fudging the facts (insinuating that she’s exercising when she's not or being faithful to whatever she’s been told to do) or being obstinate (which is usually any statement that starts with “I’m not” doing, taking, making, reading, eating, or ingesting).

That’s when I have to take the “Hoke” hat off and put my caregiver bonnet on before my chauffeured ‘busy bee’ can verbally run too far afield.

“Why don’t you just give it a try”, I interjected, exasperated by all the pointless back and forth.

“We’re here after all, if all you’re going to do is question and then end up doing what you want to do anyway we could have just stayed home!” (Yeah, I know…not very ‘faded into the background’ of me)

“Yeah, well…what do you know, you’re just a layman, too!” she said.

“You’re not going to be the one taking the medication.” (Touché!)

“I know”, I said (and she was right)

“But I am your caregiver and I’m with you 24/7 so I can see the benefit of what you do and don’t do…what you take and don’t take.”

“Yeah well…” was her response, her voice trailing off in defensiveness.

“Whether you believe it or not, we’re all on your side here, nobody is trying to make you take anything that’s going to be harmful to you.”

“That may be, but what do you know", she sneered, unaffected by my attempt at a kumbaya moment.

“Besides, nobody lives forever, you might drop dead before me.”

“From your lips to God’s ear”, I said.


Monday, August 19, 2013

Another day, another Doctor: Pt. lll



One of the benefits of having Dr G as Miss Cathy’s Geriatrician is that it’s like ‘one stop shopping’ when we go to see him.

Whenever there is a problem or question (and mom has many) we see Dr G first, and if he doesn’t have the answers he’ll know the appropriate specialist who does.

Case in point, we were back after about a month (it felt like longer) of schlepping around from one new doctor to the next, to discuss their various findings.

The good news was that (other than not remembering what day it is) mom is basically ‘fine’ (a very subjective word these days but considering the alternatives, we’ll go with ‘fine’).

Dr K, her new neurologists, added Namenda to her daily medications, Namenda is a dementia drug that is thought to work well in conjunction with Aricept (which she’s been taking since her diagnosis in 2010) to help sustain memory and issues of confusion.

One of the other specialists she saw was Dr M, a vascular surgeon. I took Miss Cathy to see him regarding the five ‘episodes’ of fainting that’s she’d had over the course of the last three years to get to the root (hopefully) of why they were happening; was it a stroke? Were they seizures? Up till now nobody could say for certain.

He determined that the problem was not the blood flow to her corrated artery (so the ‘why’ and ‘how’ of the episodes is still unresolved but luckily there haven’t been any recently).

After his examination the doctor did recommended Lipitor or it’s generic equivalent to help reduce the possibility of a stroke given her age and all she’s been through.

As we sat with Dr G in one of the (very small, very cramped) examination rooms, he went over all the notes from the other doctors, the things put in place and their recommendations moving forward.

There was a little debate (more between Dr G and himself than with either of us) as to whether or not to put mom on the cholesterol-lowering drug.

Dr G said that while Lipitor is a valid recommendation his concern was Miss Cathy’s various other health conditions; diabetes, Alzheimer’s, high blood pressure and anxiety. So he wanted to be careful that any new drug introduced into her system wouldn’t have either a negative effect or counteract the effectiveness of a current medication.

It seemed at first that he was considering adding the ‘statin’ to mom’s meds and said as much.

Miss Cathy’s response was, “I don’t want to take that. I’m taking too many pills as it is.”

I sat in a corner of the room on what looked like a banquette built for a child or as an afterthought next to a small sink and supply cabinet. There was barely enough room to contain my ever expanding ass and irritation as I eavesdropped on their tête-à-tête.

Dr G smiled and said, “Of course that’s what you say about every one of these pills that we give you to take, so lets just consider this for a minute.”

‘Points’ for Dr G! It may not sound like much but that was one of the rare time that he didn’t just acquiesce to her protestations…..we might just be getting somewhere today.



The Meds discussed in this Blog Post were:

Aricept: is used to treat confusion (dementia) related to Alzheimer's disease. It does not cure Alzheimer's disease, but it may improve memory, awareness, and the ability to function. This medication is an enzyme blocker that works by restoring the balance of natural substances (neurotransmitters) in the brain.

Namenda: is used to treat moderate to severe confusion (dementia) related to Alzheimer's disease. It does not cure Alzheimer's disease, but it may improve memory, awareness, and the ability to perform daily functions. This medication works by blocking the action of a certain natural substance in the brain (glutamate) that is believed to be linked to symptoms of Alzheimer's disease.

Lipitor: is used along with a proper diet to help lower "bad" cholesterol and fats (such as LDL, triglycerides) and raise "good" cholesterol (HDL) in the blood. It belongs to a group of drugs known as "statins." It works by reducing the amount of cholesterol made by the liver. Lowering "bad" cholesterol and triglycerides and raising "good" cholesterol decreases the risk of heart disease and helps prevent strokes and heart attacks.