This is familiar territory, but I didn't expect we'd visit, again.
    Although we don't have a doctor's appointment until Wednesday, Mom's doctor called today to tell me that, rather than improving, her anemia is getting worse.
    Getting worse. After pumping her up on iron supplements and iron rich foods, it's getting worse. It looks as though the next step is the step we avoided last fall, The Search for Internal Bleeding.
    My gut tells me that she is not bleeding internally but, then, it is her gut that is at issue, not mine. I've been poring over a lengthy article about anemia I got off the web, the one with the most information in it and the easiest for me to comprehend. I get it, now, why her doctors want to do a colonoscopy. On the one hand, she has some indices that point to Anemia Due to Chronic Disease, not due to internal bleeding. On the other hand, she has some indices that point to Iron Deficiency Anemia, usually due to internal bleeding. Her indices are confusing, at best, but because iron therapy sometimes works (it wouldn't always work if she had Anemia Due to Chronic Disease) internal bleeding finally has to be eliminated.
    She and I were both reluctant to have her colonoscopized (? on form) last fall. There are a variety of reasons, some of which were to-the-moment and no longer apply. For instance, she was recovering from severe dehydration and I was not willing to risk another blood pressure crash by making sure her colon was squeaky clean in one day. As well, although my mother tolerates tests well, she is not one who believes that invasive testing is a good idea. It was not that her colon was going to be invaded, it's that she was going to be invaded. As well, her anemia disappeared after iron therapy the first time. In fact, all problems disappeared. But, iron therapy isn't doing the trick, anymore, or, at least, sometimes it is and sometimes it isn't. So, it's time to start looking for internal bleeding.
    When we go through an episode like this (which is, as it turns out, a continuing episode that started late last summer) my thoughts often turn to what bodies do when they are on the last stretch. That last stretch can be a long one; in a relatively healthy individual, like my mother (when she is not anemic), it can last years, I think. At what point does one determine, either for themselves or someone else, when it's past time to try to make life better and switch to making life more comfortable?
    My gut is also telling me that my mother is still amenable to making her life better. I don't think I'm beating a dead horse by assuming that her anemia can be successfully treated. I know there is a good chance that, treated once, successfully, it will come back for treatment, again, possibly in a different form. Iron abnormalities are fairly common on my mother's side of the family and do tend to become worse with age. My mother, in fact, has had the abnormality, many years past, of having too much iron.
    The literature has wonderful tricks, though, for me. I want to see my mother more energetic and less apathetic, if possible. I want to see her move around more by choice with less hesitation. Here, again, in this literature on anemia, mention is made that symptoms of anemia in the elderly are, well, the same as with many diseases in the elderly; lowered alertness, fatigue, lethargy, shuffling gait. These are exactly what my mother is suffering, which give the appearance of a mild form of depression except that all are somatic and exclude the neurological. The underlying "promise" is that if the disease is addressed, the symptoms will decrease. But, there is no cure for aging. It isn't, at this point, nature's intention for aging to be cured. If, as humans, we find a way to cure aging, then, at that point, it will be nature's intention. But, we're not there, yet.
    I want all those underlying promises that I read in the literature describing my mother's dis-eases to be true. I want my mother's vitality to freeze at a point that allows her mobility and enjoyment in her last years, after which she simply falls over dead or dies in her sleep without warning. This isn't what usually happens, though.
    I am sitting here shaking my head, closing my eyes. All I can think is, here we go again. At least this time I think it is necessary. Last time I didn't think it was and, at that time, I was right.
    My mother is not thrilled but, she's a trooper. My only other thought, now, is that if it turns out that she is not bleeding internally but is somehow injured by the procedure of the colonoscopy, well, let me put it this way: I have done my best, I know I have, to see to it that this procedure, and any other procedures, are not done to my mother for such cavalier reasons as, "we could use the history", which was argued (unsuccessfully) once before when I expressed concern that it seemed a little suspicious to me that without being able to adequately explain why, doctors wanted to shove her onto the gurney and under a scope awfully quickly. I have researched more than most other medical clients, I am aware of the complexity of the issues involved, and I know I was right to disagree with the procedure in the fall and I know I am right to agree with it (as this point, anyway), now. So, if any physicians do harm to my mother in the guise of a colonoscopy that doesn't turn out to be necessary, my rage at the medical establishment will know no boundaries. This is the one aspect of this part of our current adventure that I know for certain.
- posted by gail rae @ 16:05   email...this post