Happy Father's Day
    I doubt that we'll talk about my father, my mother's husband, today. Coincidentally (if there are coincidental events), Mom stayed up quite late last night while I played tapes of the show "Cosmos" I'd checked out of the library. Both the music and the show were two of my father's favorite productions. Throughout the playing of the episodes I thought of my father. My mother remained silent and engrossed. Normally I would have mentioned the subject of my thoughts during 'down' periods when the tapes were rewinding, but last night I sensed that my mother was making the episodes hers, so I refrained. At one point I stopped the second tape and said, "You know, I love watching this show. It makes me feel wonderful to be human!"
    "I was just thinking how wonderful it is to be a part of this...," she paused as she moved her arms to encompass Everything of Which She Is Aware and All of Which She Isn't.
    "Incredible creation?" I said, trying to put words to her thoughts.
    "Well, yes, and more," she said, and continued outlining the circumference of her ineffable thoughts with her fingers.
    I was pleased to hear this. I remember that one of my father's delights in watching the series was that it encouraged him to contemplate how insignificant humans are. I also know that, although my mother did not 'take on' my father's thoughts, she also didn't loudly assert her own, and, I sometimes think, didn't fully appreciate her own thoughts. Now, in the 18 years since my father's death, she seems to be owning her thoughts, feels as though she can disagree without being challenged...
    I love my father. I am, literally, half his, having noticed early in life that I got exactly half of his entrenched pessimism and her entrenched optimism, the contemplation of which always delights me. Much to my surprise, though, I found myself thanking him, last night, for allowing my mother some time alone here beyond his life to, again, be her unfettered self.
    Although her feet and legs have not been swelling, it seemed to me as though her belly and her face were just this side of dangerous bloat last night, so, with her dinner (we split a hearty rib eye, some homemade fries and my 'famous' It'll Make You Pucker cole slaw) I gave her a quarter of a 40 mg furosemide tablet and worried that even this might be too much. This morning, I notice, it seems to have done the trick without causing her to soak her bed from excessive sweating and bladder leakage. Hydration is a tricky business with my mother. She doesn't experience thirst as reliably as she used to and has never been much of a water drinker. Last fall, her physician dehydrated her too quickly and she experienced a blood pressure crash (which appeared to me, at first, to be a stroke) scary enough to land her in the hospital for a night. I am determined, now, not to have that happen again.
    The doctors were and are reluctant to call her episode a blood pressure crash, despite STAT CAT scans, MRIs and a constant monitoring of her vitals for 24 hours, although they were unable to call it anything else. It wasn't until I described her episode to two people who have extensive experience as kidney dialysis techs (one of which is my sister) that they both immediately identified the problem, which is common (and sometimes deadly) during the dialysis of patients in frail health. Although the sudden blank appearance, the bugging eyes, the aimlessly swaying head, the loss of the ability to 'be where one is' and the retention of consciousness despite the lack of awareness are signs of a crash, they are also common to stroke onset. The clinchers were three other symptoms: The episode lasted less than two minutes, she remained seated upright throughout and immediately following the episode she experienced a complete bowel evacuation. She recovered so quickly, in fact, that she took herself to the bathroom before the paramedics arrived and delayed her departure to the hospital until she was done in the bathroom, much to the paramedics' frustration.
    When I think about it, I am surprised that no one, including the paramedics, took any of the above into consideration. Her physician has, with some reluctance, decided to humor my interpretation of her episode, but I suspect he still believes that it was something else which he has labeled a "Trans Ischemic Attack" and an "Altered Level of Consciousness", explaining that these labels are often used when physicians aren't sure what happened. However, since I am quite sure I know what happened, I have been guarding against dehydration (and, now, over-hydration) since, and she's had no further episodes.
    I think one of the most valuable lessons I'm learning as I care for my mother is that physicians should be considered health care resources (and, sometimes, partners), not authoritarians. I've never considered them mini-gods, as large segments of society often have, but I also didn't realize that gently sparring with physicians and questioning their opinions and diagnoses allow them to be a much more valuable resource than I've previously believed.
- posted by gail rae @ 11:24   email...this post