I lost a little piece of heart, yesterday...
...as a result of my mother's much anticipated (by me) colonoscopy follow up visit with her PCP. I was very excited about the visit. If you've been following our colonoscopy adventure you'll recall that as a result of her unanticipated and spectacular revival immediately after the procedure I decided to take a few steps to keep the revival going, including not continuing the metformin or her iron supplements.
    She was in prime condition for the appointment. Throughout the morning she repeatedly questioned me as to why we were going at all, considering how good she felt. [When I say that since the procedure the clock was turned back on my mother by two and half years, it is important to keep in mind that my mother's mental creativity began long before then, so being in excellent shape continues to include an eccentric memory, although somewhat less so than previous to the colonoscopy.]
    The appointment so bewildered me that I haven't been able to write about it, although I have been able to think of little else since. To begin with, although her PCP noted that she looked good, her lungs were clear, she sounded good, all her stats were nicely normal (except her blood sugar, which is running a bit on the high side, although always below 200, usually below 170, and when I can get her moving for a bit during the day, which has been possible about every other day since the procedure, it snaps right back to normal) and her blood oxygen level was 93 (which, I noted, shocking the doctor, "...is amazing, considering that she's been without oxygen since her concentrator went on the fritz Saturday night"), once all the physical nitpicking was out of the way he lit into me for taking her off metformin and iron. Then, after acknowledging the results of the colonoscopy and agreeing that it had been unnecessary and that he had no problem with never scoping her again, he refused to speculate on what accounted for her recovery, dismissed my ideas that a combination of the bowel cleansing and keeping her off metformin and iron had anything to do with her recovery, continued to insist that she is still bleeding inside somewhere although, "...it must have stopped, again, like it did before; it's probably a valve or something...", also dismissed the possibility that medications could have been suppressing her bone marrow function (MCS warned me about this) by telling me that if this were true her hemoglobin would not have been so low, bartered like a kiosk trader to get me to put her back on iron (two tablets a day; he wanted three, I wanted one, we compromised at two) at least until the hematologist gets a chance to review everything, seemed to not be able to remember throughout our 15 minute appointment my severally mentioned vow that I would not put her back on metformin, not at any dosage, although I would be amenable to trying other medications until my mother had securely embraced lifestyle habits that would keep her blood sugar normal, said that, yes, indeed, there were other medications that could be administered but dismissed doing anything about this yesterday and his last words to me were, ironically, "Well, if her blood sugar goes a little high, you can always give her half a tablet of metformin," despite me having scrapped this medication for my mother. Added to this, in order to try to get me back in line he used the veiled threat of the possibility of blood transfusions if her hemoglobin didn't recover; using this to underline what he felt is the necessity of keeping her on iron.
    Whew! Big breath! I'm boggled. It is as though he gave absolutely no thought to anything I conveyed to him before the appointment, nor the numbers and his in-the-flesh observation during her appointment. I hope he was just having a bad day. I hope that it was one of those days for him (which we all have) where one gets stuck in a rut and simply can't get out until that day fades into the next. His reactions seemed to be completely out of character for him, almost as though he was feeling threatened (thus, he passed the 'favor' along to me). I went out of my way to assure him that I do trust him, but that my fundamental trust resides in my observations of my mother.
    In the meantime, I ran the information about hemoglobin past MCS this morning and she was stunned, telling me it isn't necessarily true. As well, because my mother is clear enough, now, to remember his threat, she's insisting on taking the iron, even though her history, pre-old age, has been that she does not do well on iron supplements.
    Although I was feeling defeated and disgusted yesterday, I'm not today. I will administer iron to my mother, although I'll take her off it, again, if her vitality sags and her color dims (which sometimes happens to her on iron if she's overdosed). It is only two weeks until we see the hematologist, so I'm hoping that the iron, while I don't expect it to do her any good, won't do her any harm, either.
    In the second meantime, although my mother awoke this morning a bit on the slow side, I gently but firmly maneuvered her into going to Costco with me and getting her out, once again. As was true on Monday, walking around pushing a cart greatly improved her spirits and her energy level. She had a fecal accident toward the end of our trek, although she was unaware of it and, since she was wearing paper underwear, the accident was not visible (although it was detectable by smell). Since I hadn't thought to bring supplies with us I didn't address it until we got home. Interestingly, her spirits improved even more once she'd eliminated, so my guess is that her bowels are just getting used to functioning normally, again. We'd had two relatively slow days in a row, especially yesterday. Although we went to the doctor, she was up and moving around very little. Today's accident provided a lesson for me that I need to get her moving at least once a day, just to allow her body to function properly. Sitting up will no longer do the trick now that she is recovering to a higher level of somatic functioning.
    Her sense of thirst and hunger have both returned and I only occasionally, and not even every day, need to remind her to drink something. I haven't had to tempt (or, sometimes, badger) her to eat since the colonoscopy. I've been noticing the last few mornings, as well, that she is getting up at night and eating, which is fine. It throws her blood sugar out of whack a bit but I know she is responding to genuine hunger and what we need to do, now, is adjust both medication and habits to take into account the fact that my mother has always been a much more enthusiastic snacker than meal eater, despite her love of the restaurant experience.
    Tomorrow we are planning an overnight trip to Prescott. She is enthusiastic about this, especially since it involves a book club meeting. She is looking forward to the social activity and, as she says, "the change of scenery".
    The most heartwarming part of the day occurred as we left Costco. The employees there have become so used to me shopping alone that a few of them mentioned their surprise that I even had a mother. When the woman at the door checking people's receipts as they left noticed my mother she commented that I must have visitors. "No," I said, proudly, "this is my mother. She's been under the weather for a long time, but she's back in the sun, again, so she'll be accompanying me, now."
   "Good for you!" she said to my mother, and drew a smiley face on the back of our receipt for her. When we arrived home, after I'd unloaded everything, cleaned her and her slacks and started putting things away my mother asked, "Where's that receipt?"
    "Oh," I said, "it's right here. I was going to throw it away."
    "Don't do that, give it here."
    Welcome back, Mom!
- posted by gail rae @ 17:05   email...this post