Mom & Me One Archive: 2002-2003

As of May 1, 2010...

2010-04-29T21:20:00.001-07:00

...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://momandmeonearchive.blogspot.com. This section of the journal will also remain at in it's domain directory, so accessing links should not present a problem.

If you've hung in here with me...

2004-01-04T01:21:00.003-07:00

...or have stumbled upon this site while searching you know that I've been, well, overwhelmed enough with the intensity of taking care of my mother through a recent back injury that I haven't been updating here, at all.
    Aside from having to quickly become more enveloped in my mother's life than I imagined I was gracefully capable of doing, I also ran into some technical problems with the software on this site that were driving me insane and decided, about the time of my mother's fall, to fix and redesign the site and look for another journaling site. I've found it. The address is here: The Mom & Me Journals dot Net. It is a continuation of this journal. Throughout the next few weeks this entire journal project will be restructured but will remain easy through which to negotiate. None of the material will be lost. I will be making much more frequent postings, probably lots shorter and much more stream of conscious and will be doing a lot of cleaning up around here.
    In the meantime suffice it to say that my mother is a challenge but is doing fine, relatively speaking. I'm not afraid that she is going to die in the night tonight, or any other night in the immediate future. She is much more mobile than she was the first few weeks after her initial fall. Her healing remains very, very slow and I'm still functioning as parts of her body. The present situation would be pretty weird to contemplate if it didn't seem so normal to me, now.
    I know I've mentioned to several people verbally although I don't know if I've mentioned it here, that I continue to be surprised, pleasantly but bordering on shock, nonetheless, at how well I'm handling this. I've always been afraid of something like this happening although I've imagined much worse: A major stroke, etc. If I'd been told ahead of time that this was coming I would have made the silent assumption that it would drive me crazy and I would fail the task(s and multi-tasking) set before me. So I'm glad I didn't know ahead of time. Thankfully, my attitude throughout has been stellar, much to my surprise, and this has been a big help.
    I have much more to report, but let me officially cross over to the continuation of this journal, back into regular updates as our journey continues. You'll notice above a prominent link to the continuation. That will remain permanent, as, I expect, will this post, since it will probably be the last made in this segment. This site will remain a history site will be the consolidation of all my history pages plus this serialization of this journal as an archive. You will notice in the next few weeks lots of shuffling of links and expanded link sections in order to cross-reference material. It will all be easy and all pages and sites now in existence will remain up and subject to updating and posting.
    Gotta go. See you around the corner.

What was the name of the place we used to live...

2003-11-17T13:36:00.000-07:00

...Palmas del Sol?"
    Did you catch that? "...the place we used to live...". She asked this late this morning. Mesa is in the past for her now. This wrenches my heart a bit. I know both the quantity and the quality of emotional attachment she had toward that place. I also know how well she does here, how much she likes it, how easy it has been for her to divorce herself from the mobile home in Mesa.
    It's true that we have 100% more company up here and, as such, we see our people more often. The sun agrees with my mother and we have loads of it all winter. The colors, the view, the ambiance of our property all agree with her. The last four weeks have been very hard on her due to spraining her back but we're getting through that. I'm convinced, since it was due to my mother's too good generosity of nature that got her into this fix, that eventually something of a similar sort would have happened. Now I know not to do anything around her in which I really don't want her attempting to participate. Hard lesson to learn and initiate but worth it.
    I spoke with the acupuncturist earlier. I am very confident about the appointment we made with her for Wednesday morning at 1000. Mom is hanging in there. Her color looks good (better than yesterday; she attributes this to us having baked ham last night and this morning, one of her favorite foods) and her back is still "giving [her] fits".
    Sometimes, while sitting quietly, her creative memory will dump the file that tells her she is having back problems. She'll move suddenly or in a way her back currently deems unseemly and she'll cast me a look of surprise and say, "My back!" as though this is the first time it's done what she calls "grabbing".
    This has been going on long enough. The truth is, I was leaving whether I call the acupuncturist up to her because, at the moment her debilitation gives her very few choices including small things like whether or not to drink something, whether or not to eat, etc. Since her back will eventually improve and I can see some small improvement day to day I decided to let her call the shots on this one. She hasn't been completely against treatment. One of her favorite shows though, "Everwood", features a doctor who practices acupuncture. Since I have begun talking up treatment, the show has featured two episodes in which acupuncture is used. I think the sight of the needles took my mother aback. She is used to me talking about the "acupressure" techniques I use on the soles of her feet and what this stimulation does, but the needle/electronic stimulation surprised her. It took this last weekend of me watching her wince in pain when her back "grabbed" and me bursting into sobs for me to finally take her choice out of her hands and tell her that on Monday I was going to call and seek treatment.
    At this point, a brief history of how we came to seek out acupuncture is in order (dates exact, unless otherwise stated):

October 25, 2003, 1330: Mom falls backward and sprains her back. She immediately rolls over, pulls herself to a sitting position on a low step, says she isn't hurt, then her back grabs as she leans forward.
She insists "nothing is broken", although her only experience of broken bones is decades old and is a tail bone that wasn't detected for years and, when detected, was removed, also decades ago. She is, though, moving around, the wind was not knocked out of her, she is in obvious pain but "ambulatory" so, for better or worse, I accede to her wish not to go the ER.
Monday morning, after a bad Sunday, I overrule her preference to stay out of the ER.
    "They won't do anything, just send me home with pain killers, and I don't want that."
    Which is exactly what they did. I couldn't lift her and she was so stiff and sore I wasn't sure she could move in any way she hadn't been moving over the last 36 hours. I called an ambulance, called her doctor in Mesa and we went to the ER. The stay was a little over 2 hours. They stimulated her back electronically and did a few things to her that caused her to vomit. She vomited a little fresh blood, their ministrations caused her exceeding discomfort, they did a poor job of cleaning her up, gave her a prescription for Vicodin and sent her home. With me. In great pain.
    It seems that the fresh blood was from the large amounts of ibuprofen I'd been feeding her over the weekend and that morning but the vomiting wasn't from that. However, I learned my lesson quickly. Despite the high occurrence of constipation on Vicodin and my mother's tricky-at-best bowels, I decided to give her the Vicodin. It caused extreme dopiness, which made it difficult to keep her moving as the physical therapist suggested, only barely dulled the pain, made it even more difficult to keep her hydrated, which was already more of a chore than usual and she did not feel good or look good on it. During the first week and a half of intense pain, though, I kept her on it, although judiciously.
At this point our supply of Vicodin ran out and so did suppliers. I spent this week and a half finding out that it would be impossible for us to find appropriate, and appropriately timed, physician follow-up in this town, her Mesa doctor was unwilling to treat or prescribe over the phone, our only recourse for any kind of follow-up was the ER again or Urgent Care and we both knew exactly what would happen at either of these places. In the meantime I had secured her a "new patient" appointment with a highly recommended physician here, for, unfortunately, December 1st. Now we were stuck with Time and only Time as the healer and Mom's bowels were impacting.
I administered an enema to Mom on November 5th. Although it sounds intolerable coupled with the pain of a sprained back, something told me that it would offer immediate relief. It did. It alleviated a lot of pressure, did not cause any more pain, and her spirits improved immensely.
Time does heal but sometimes not quickly enough. A friend in Prescott recommended acupuncture about two weeks ago. I talked it up and Mom sounded game until she saw the episodes of "Everwood" in which acupuncture was used. Although she is not known to be afraid of needles it gave her cause to rethink the treatment.
Two weeks hence, in utter frustration, I am now dictating the treatment.

    This afternoon, as I can, I'm going to begin updating this site and will be adding a second tier to it, the url to be published later today, probably. I'm going to slowly phase out using this auto-sitebuilder Earthlink provides and start hand crafting my pages and uploaded them via FTP. That should help keep my count straight. I've also found two new possibilities for blogging software, both of which I intend to try on the new site. I'll let you know when to switch over and provide a great big link to the continuing portion of this website. Parts of it may migrate back and forth from time to time but I will keep you updated here and on changes.
    It's good to be back.
    Later.

Wow. 10/17/03 was my last post.

2003-11-17T09:17:00.000-07:00

    Although I haven't checked (I should and I will after posting this), as I recall things were going well. The reason I wasn't posting was because the two of us were becoming quite active, almost social, in fact. Mom's health was doing well, she was getting out someplace with the aid of oxygen every day, we were beginning to "go out to eat" more, which is one of my mother's favorite social pastimes...
    Then, on October 25, 2003, at about 1330, Mom fell and sprained her back. It was a part of her character that most people would consider "good" that did her in. My mother is A Helper. She cannot resist the urge to offer a hand. On that day we were anticipating the delivery of a television that my mother would actually be able to see and hear. I had lifted our old TV, weighing a bulky but easily managed 35-40 lbs., and had swiveled away from the coffee table off of which I'd lifted it. My mother had been watching all the preparations from a chair in the dinette. Suddenly she was at my side offering to "help" me.
    "No!" I yelled, in various versions, such as, "I've got it!" and "Get away!" And, sure enough, as my mother simply reached underneath the TV the muscles in her lower back grabbed and she fell flat on her, well, back.
    Yes, it is sprained, lower lumbar region, right side worse than left but no bones are broken. I took her to the emergency room in medical transport and brought her home in our LUV truck. She's been in pain of varying degrees since. Finding medical follow-up has been frustrating. Our only choices seem to be taking her back to the ER or taking her into Urgent Care. No private doctors have been available for immediate follow-up although we have made a "new patient" appointment "not a follow-up to your mother's current problem" the appointment-maker advised me twice, with a highly recommended new doctor in the area. Earliest we could get in? December 1st, 2003.
    She was on Vicodin, both 500 & 750 mgs, for almost two weeks. When we ran out, keeping her on 600 mg ibuprofen every 5 hours when she's up seems to be doing exactly what the Vicodin did without the constipation that finally required me administering a much resisted yet relieving enema to my mother.
    We continue to have problems with severe watershed when she is sleeping although it is abating in comparison with the first week to week and a half. She is moving more, although not much more. She is staying up more, although not much more. And she is always in pain, always wincing from a random back spasm.
    I've been trying to get her to assent to seeing a highly recommended acupuncturist in the area. Although she's not prejudiced against alternative medicine, she's taken some alternative treatments from me well, the idea of having needles stuck in her has not appealed to her and she has believed that she can handle this and it will get better day by day. This weekend, though, I broke down and started sobbing when I simply couldn't take the physical evidence of her pain anymore. I told her, no more choices (I'd been hanging onto letting her make this one choice, as she, presently, has very few choices left to her while I companionate her through this healing). I'd be calling the acupuncturist on Monday.
    My mother must have been psychically engineering the call behind the scenes. The acupuncturist is in Tuesday through Friday, 0800 - 1700.
    I'm very excited about the possibilities. At one point, which my mother forgot, I told her I'd sign up for treatment of something if she would and I'd go first so she could see whether or not I perished. Although I finally discovered the source of the carpal tunnel syndrome I've developed over the last few months (the way I massage my mother's feet) and changed it, the original bizarre development continues and makes other things difficult so I could have that treated. I think, though, that my mother may have forgotten this unsuccessful lobbying technique of mine. If she doesn't mention it I'll wait and see how her treatments go, or, for that matter, whether the acupuncturist will feel she can help my mother. It has occurred to me that she may have nothing to offer my mother. I hope I'm wrong about that.
    I've been taking fairly regular blood sugar readings. Those still need to be posted. I'm considering switching to HTML by hand, with which I am fairly handy and restarting the log like that. I think I won't continue to get the inaccurate "over published" notice if I hand build and ftp my site. I am, as well, trying out a few other web log facilities. I will probably switch. In addition I will not be getting rid of past information but adding it with the new. Not, however, through an auto site builder. So I may very well open up a totally new site shortly with this site remaining as history.
    We'll see. My intense involvement with my mother, essentially becoming her body, is pretty draining of both time and energy. I expect this to alleviate but I'm not sure when. It will surely continue to affect the work I'm able to do on this site.
    As well, as a reminder to myself, I have other things to report about sisters and friends and medical communities, which I'll attempt to do...
    ...later.

Company, company company.

2003-10-17T00:02:00.000-07:00

Company's not the only reason I've been here much less frequently to post but it's one of the major reasons. This time though, this year, I've taken well to all the company, which is good because we have one more company ridden week to go.
Other reasons for not posting anything:

Mom is decidedly more active (for her) and it is relatively easy to get her out and about so I've been taking advantage of this. As usual, she tends to think going out is a good idea then resists when it comes to getting ready. Once we're out, though, she's a live wire for the rest of the day and often finds it unnecessary to nap in the afternoon.
I'm feeling much more settled, now that we've decided to get rid of the house in Mesa and settle down. I've been working the house and the yard like crazy and immediately jump into every urge I have to do this.

    Today (Thursday) we went for flu shots. The line was long but the county health people were extremely helpful and provided two chairs for Mom, one two thirds of the way down the line and one close to the beginning. I kept an eye on her and her oxygen while I moved us up the line. Most of the time I was out of her sights but she was in mine. This gave me a chance to observe her "in her element" without my presence affecting her behavior. I believe she was the oldest person there. Everyone who passed her in line talked to her. Her eyes glittered with delight at the chance to do some up close people watching and people chatting. As I watched her I was reminded of the book club friend of mine who, when I mentioned that my mother was "ancient", corrected my description by telling me Mom actually came across as alert, proud and of generous spirit, obviously a one-time beauty who was used to being noticed and approached and who continued to think of herself in this way. I had a great time observing her and chatting up people in line, myself.
    I know I have a lot to make up here. I'm not completely finished fixing the pages that this auto-site builder mangled, I have a good half month of blood glucose levels to record, can't really remember how I've altered her med administration from day to day although I've been doing that all along and now have a new medical toy, a wrist blood pressure monitor. I've only taken her BP once and it seemed in line with what she normally reads at the doctor's office. I will be starting a fairly regular reading and recording of her blood pressure once I'm able to get back to this site on a regular basis. In the meantime, we're doing well, both of us, life is busy and good and I am exhilarated and grateful.
    Thankyou.

I'm back, sort of...

2003-10-15T16:53:00.000-07:00

...to a short purpose but intend to be back later this evening or tomorrow after flu shots. The purpose is this:

I am curious about the person who pulled the following search on this site, last week: "anemia related to glucophage use". I would very much like to find out what you've heard of this and what your experience and/or information is. If you come back to this site please contact me through my email address at the bottom of the page or through the guest book, in which you can leave either a public or private message. I searched it within my sight as well to see if I had used this phrase. I hadn't but this is a subject I am very curious about and would like to see if you have heard of this anywhere but on this site. Thank you, in advance, if I should catch you.

Later.

We've fallen hard, today, out of visit week.

2003-10-10T23:50:00.000-07:00

MCS & BIL are headed back to Colorado. I wish Mom and I were able to take two days on the road to drive out of visit week and contemplate, in the womb of road noise, all that happened. Instead, we're reeling from the drop back into our two-sided life.
There is much to report including updated blood glucose numbers. There are gaps in my recording and lots of blips out of normal range but none of this affected my mother's high merriment, deep satisfaction and wry vitality throughout the week. Some important decisions were made about living arrangements that I'll cover as I catch up over the next few days. Tonight I just want to mention that a very successful visit week is over, I haven't forgotten this site and more reports will be forthcoming.

My mother said something curious, thought provoking and peculiar, today.

2003-10-04T00:00:00.000-07:00

    I'll cover the context later when I'm not so tired but I want to record what she said as exactly as I remember it before losing more of it in sleep than I've already lost in wakefulness and exhaustion.
    This is, unfortunately, a paraphrase, but very close to the original:
    "All these moves I've made and none of them has been an upgrade."
    We were speaking, specifically, of houses. We were arguing about houses, heatedly discussing whether we could still afford two houses (me speaking financially, although she accused me of speaking emotionally; her speaking emotionally, although she denied this). It was then that she dropped this bomb on me, a bomb with a variety of explosive effects: A bomb with several separately timed release segments.
    I have known since, it seems, forever that my mother has a dream home. She has had bits and pieces of it in some of the houses she's inhabited. We had, on Guam in one of our homes, "Quarters A-2" (so named because it had once, just after WWII, been the commanding officer's quarters) an almost industrial sized kitchen, for instance, with loads of cupboard, pantry and counter space and a large attached utility room. She loved these areas. Most of our family's life went on in the kitchen. My mom's and dad's farm in Wichita Falls, Texas, also had such a kitchen with a somewhat more recessed dining room and loads of other rooms which my mother loved but with which she and my father did nothing. It was also a "farm house" which my mother loved. Her dream home is part farm house in that it is on a farm but is more a type of split level ranch style mansion/home featured in the late, great, evening soap "Dallas", a program which she loved chiefly because of the Ewing's home.
    I have memories of my father and her collaborating on detailed floor plans of her (yes, "her"; I think my father adopted his because she had one) dream home.
    Certain aspects of her dream home have changed over the years. She now dreams of homes much like the classic "Victorian style" (not to be confused with Victorian) historical homes surrounding a one mile or so circumference of Prescott's Courtyard Square.
   I know she's never had her dream home.
    The point of me mentioning this, though, is that, until today I never knew how badly she has wanted this home of hers and how far she feels she is and, apparently, has always been from it.
    Knowing this has already had more than a few repercussions on my wondering about her, our companionship, and our lives together (which will remain together until she dies if I don't precede her in disability and death).

It doesn't look as though anyone in the world has noticed...

2003-10-01T21:55:00.000-07:00

...that recently I haven't posted every day and I'm a few days behind on recording blood glucose numbers on Mom. I've been taking them. It's just been a very busy couple of days for several reasons, not the least of which is that I am preparing for a much anticipated visit from MCS & BIL. The visit will be quite active and intense. MCBIL is going to help me out with some much needed minor home repairs in both our houses. I expect that they will be very curious about Prescott and ready to savor the area with my mother and me. We also have lots to talk about including the possible sale of the home in Mesa and a permanent move up here. My journal entries, blood glucose reports and fixing of this website will continue to be highly erratic for exactly the next week and a half.
I'll be checking in as I can, posting as I can, but, mostly, enjoying the very active period coming up shortly.

I am very tired, tonight...

2003-09-29T01:03:00.000-07:00

...but I wanted to post some significant events of the last few days.
    Yesterday, although I allowed Mom to rise late, I had a purpose. I decided the previous evening to begin in earnest my plan of getting her out at least once a day, as she is again showing signs of wanting to spend all day and all night in bed. So, I did, with much protest from her. I also bugged her about drinking fluids all day long. As we made our way through Pet Smart and Costco (both brief visits, the entire trip with oxygen, and me relenting at Costco and letting her sit out my search for our last of three items), I managed her cart handling (to which she tends not to pay attention) like a kindly drill sergeant. She wanted me to walk before her and she'd follow but I told her that when I walk ahead of her she doesn't watch her cart and where she's going, she watches me and slams into both things and people, so we'd walk together. We had one more place to go after Costco, the local grocery to pick up a few items. She was clearly tired though, and hungry, wanting the burger and onion rings I mentioned (I wasn't actually able to get her out until very late in the day...she balked the entire day away), so I allowed her to sit the trip out in the car, went for ice, was gone maybe 10 minutes.
    When I returned to the car she'd had a shitting accident. I wasn't surprised. On our way home I was low key about it. As I drove, though, internally my frustration level rose to a heretofore unreached peak. By the time we arrived home I was no longer a kindly drill sergeant, I was somewhat closer to the drill sergeant in Full Metal Jacket. I decided I'd had it. I needed her cooperation to get her going and I wasn't going to take no for an answer.
    I hit her with my best shot. After I'd cleaned her and unloaded the car I directed her to the dining room table and ordered her to sit. The following is a paraphrased version of what I told her, no holds barred.
    "Look," I began. "I'm angry about this shitting accident, today. There was no excuse for it. It was, again, a result of your insistence on not moving, not even sitting upright, insisting on going to bed, insisting on walking away from full bathtubs, insisting on doing absolutely nothing to improve your life. I've had it. I am no longer sympathetic to your lethargy. I'm not interested in cleaning up any more of your shitting accidents unless they are absolutely necessary, and this one was absolutely unnecessary. There was no dietary reason for it. There is no disease that can be blamed for it. It was strictly a result of your lethargy. I'm not going to allow this anymore. From now on, until you've figured out what's good for you, I'm going to determine that. You think you're stubborn. Well, lady, let me tell you, when I get frustrated and angry I'm hell on wheels and you can set your watch by that. I'm not going to be sympathetic anymore. I don't care how stubborn you can be, I'm not going to let you crawl back into bed anymore. I'm not going to allow you to wallow in boredom. I'm not going to let you refuse to do everything that you need to do. I've had it up to here (indicating a level, with my hand, high over my head), so much so that I've been thinking over the last few days that maybe I need to put you in a nursing home. But, you know, that would only be good for me, not for you, so that's not going to happen. I can guarantee you though, from this day forward, if you have any ideas about wasting the rest of your life in bed and shortening it like that, you're going to wish you were in a nursing home. I've finally realized that you don't need sympathetic kindness, you need someone to kick your ass and I just pulled my boots on and I'm ready. When I say 'jump', from now on you had better jump or I'm going to kick you into a jump until it gets to the place where you want to jump on you're own. At this point you are perfectly capable of turning toward life, you're just being lazy now and I'm not going to let that continue. It's bad for you, it's bad for me, and it's stopping right here, right now. I'm tired of hounding you to drink water. I'm tired of losing those stupid battles we have over whether you're even going to stay up for the day. I'm tired of all this shit and I'm going to see to it that I pull both of us out of this mire or we're both going to die of my trying. Do you understand what I'm saying?"
    She had been staring at me the whole time rather than looking down or out the window as she usually does when I 'lecture' her. "Yes," she said, not meekly but with some surprise.
    "Do you understand that I don't care anymore whether you want to do what I tell you needs to be done? I'm going to see to it that you do it anyway and I'm going to expect you to start taking up the slack and becoming more active in the quality of your life?"
    "Yes." That was a firm, although still surprised, yes.
    "Do you understand that you're perfectly capable now of doing this and that I've had enough experience with you and your body in this last year to know when you are capable and when you're legitimately not?"
    "Yes." A clear, firm "yes", as though she was beginning to resolve some things within herself.
    "Do you remember how I always say when I'm trying to get you moving that I'm not asking you train for the marathon?"
    "Yes."
    "Well, guess what. I've changed my mind. Marathon training begins right now, and the marathon is your life. Do you get that?"
    "Yes."
    Today we started training for the marathon. It went well. I let her sleep in until almost 11:00 because she stayed up very late last night, as did I. Once she was up I kept her going all day. She bathed. I told her she's going to bathe everyday from now on. She tried to get out of going along on the errands we ran. I told her she didn't have a choice. She tried to take her oxygen off once during the trip. Instead of gently reminding her to put it back on I scolded her; not harshly but enough so that she didn't take it off the rest of the trip. I wasn't unreasonably hard on her. At one point, at the grocery, she needed to rest and I let her sit while I went searching for soy sauce. I forced her to become involved in the decisions we made about what version of Monopoly to buy (we decided we needed another game last night), what vegetables to use in dinner tonight, whether to get soy and make teriyaki sauce from scratch or to buy commercially prepared teriyaki (we decided on the former). I only had to remind her to "remain alert" once with the carts she pushed. From that point on she was alert. She didn't feel the need for a nap today but, frankly, I didn't give her a chance to think about a nap. I gave her a water bottle to carry in the car because she mouth breathes when she's on oxygen and it dries her out and I'll be damned if she didn't drink out of it on her own without being reminded. I depended on her to be as alert as she could be, and she was.
    At one point when we were discussing plans for the rest of the week and she started in on her childish, incessant "Why's" to try to get me to delete a few of the activities from our list I said, "Do you remember the conversation we had last night?"
    Her eyebrows arched and her vision focused. "Yes," she said.
    "Well then, you know the answer to that question. Don't ask me again."
    Amazingly, without me constantly bugging her to drink water, stay up, do this, do that, she was well hydrated this evening, had a hearty appetite, was lively and animated all day, looked good tonight. When she finally decided to go to bed she was genuinely tired, not bored.
    Maybe, just maybe, I'm finally figuring out how to handle this woman in her Ancient One years, this woman whom I love at least as much as I love myself. Maybe this time we're really on our way out of the morass of the last few years.

My problems with this auto-site builder continue.

2003-09-27T11:31:00.001-07:00

    Almost all the time I have to spend on the computer is involved in resetting the pages. It's a slow process even though I have copies of everything. Trellix, as a server side piece of software, will not recognize pages uploaded from my computer, thus, will not open them for editing, even though they are displayed normally when accessed. I have to reset all the pages through Trellix so they are available for editing. Thus, this post and, I expect, most of them for the next several days, will be short and sweet, much to those few of my readers' pleasure, I imagine.
    There is something I want to report from yesterday evening. My mother is hard of hearing. This has been the case in one ear since she was a teenager and in the other ear for a few decades. Throughout the years our entire family has continually suggested that when she watches TV I turn on Closed Captioning. She is not comfortable with subtitled movies, though, so I have always accepted her refusal.
    Last night, there was a show on that she and I wanted to watch. Our TV in Mesa, an old one circa the late 70's or early 80's, delivers full, rich sound which is fairly easy for her to interpret. Our Prescott TV, although only 6 years old and both digital and cable ready, has horrible sound that delivers very little mid-range vibration and almost no low-range vibration. It is very difficult for my mother to hear and somewhat scitzy for me to hear. As the volume goes up, sound clarity goes down. My mother became frustrated last night trying to negotiate the program and I was distracted by my efforts to modulate the volume minute-to-minute to her advantage. Finally, on a whim, I decided to turn on Closed Captioning. My mother complained when I triggered but I reminded her that one of the movies we regularly watch that she and I both enjoy is a Dutch movie with English subtitles, Antonia's Line. She has no problem with that.
    Within minutes she was riveted to the set rather than easily distracted by her environment. A half hour into the show when I asked her how she liked CCing.
    She said, as is typical for her, that she "wasn't sure" she "liked it" but the couple of times I played with the CC settings to see what was available to us she complained when the script disappeared from the screen.
    It seems we have solved the problem of her 'hearing' our Prescott television. I'm not sure how I feel about this. On the one hand she is absorbing much more than before. On the other hand, because of the quality of the sound, she has typically watched much less television in Prescott than in Mesa. I think that situation is going to reverse, now. But I'm pleased she is enjoying her programs more.
    "We should have tried this a long time ago, Mom. You know, everybody (in our family) has suggested this for you at one time or another," I said during a commercial toward the end of the show.
    "I believe you're right," she agreed.
    We briefly discussed hearing aids again. When she was watching an Ellen episode that featured Pat Benatar yesterday, I noticed and pointed out to her that Benatar was wearing two hearing aids. I explained to her that hearing loss is typical of many rock stars and some of their fans.
    Although she was intrigued, her final response was (she's so funny, I love this response), "I know one day there'll come a time when I'll have to consider hearing aids. I don't think it's necessary yet."
    I'm thinking that she assumes that maybe when she's 110 hearing aids might be a good idea. My mother: The woman who still believes, at 86, despite her extraordinary practicality about death, that she will never die. This is one of my favorite aspects about her.

I 'm still having major problems with Earthlink/Mindspring's...

2003-09-26T01:08:00.000-07:00

...auto site builder, Trellix (I want to be sure and get that name in). I am now beginning to slowly and laboriously readjust and reset my pages. Bear with me...it may be a few days before I get everything back to normal and start posting normally, again.
After doing a little research, including looking up Trellix on the web, I'm also beginning to understand that the reason Earthlink/Mindspring tech support is not handling this problem adequately is that the provider of the site builder software appears to be in transition itself and may not be providing adequate tech support to their customers. Part of the problem may also be that Earthlink newly belongs to Level3. Those aren't excuses but they are probably hang-ups in the tech support aspect. At any rate, I've figured out a few work arounds and will, in time, begin building (and rebuilding) my pages by hand. I've learned my lesson regarding ISP provided auto-site builders. I'm hoping and expecting my problems to be solved by tech support but I've had so many problems with this auto-site builder that I think I've figured out that it's best not to use online auto-site builders.
Damn. And, all I was trying to do, when I decided to use it, was to save myself some time. Now, that time is being consumed negotiating the problems with Trellix. Oh well...one more lesson down, millions more to go...

Although we had planned to visit the strangely-built new mall...

2003-09-25T11:54:00.001-07:00

...in Prescott today, Mom awoke with the intention of "attacking" her room and that's fine with me. She's moving slowly as usual but seems devoted to remaining "up on end" (one of her historically famous phrases) so this seems like a good day to get her room in order and begin going through her stuff.
    Since we're remaining home and I won't need to negotiate her blood glucose levels through eating at a restaurant or, for that matter, peach cobbler, the rest of which has been frozen, I've decided to try a day without metformin to see how it goes. I'll also be starting her on a modified regimen of detox tea put out by Yogi Tea. I used it briefly a while back and wasn't able to determine whether it helped her but I've been thinking, since I'm using more metformin on her than I anticipated or like using, it might help keep her liver and kidneys in line. The link above goes right to the type of tea I'll be using, which advertises itself as a liver and kidney purifier. I will, of course, report on any determined or assumed effects.
    Regarding our "bad" day, immediately followed by a "good" day: I'm critically aware of how my mood affects my mother's mood. Although typically not affected by other people's moods, the older my mother gets and the more dependent she becomes on those surrounding her, the more likely she is to react, in very subtle ways, to other people's moods, most especially mine. I've learned (and am still learning, obviously) to try to modify what I broadcast at her because she is extraordinarily dependent on me.
    It is extremely interesting for me to become acquainted with my mother as a person dependent on others, as this is a striking change in her life-long approach to life. I am by nature extremely emotional. The control I exert over my emotions is, most of the time, to simply let them flow and express them. Thus, when my mother's dependence is at a high level I allow myself to be deeply affected by her and I show it. I remember some months ago when we were going through one of the worst episodes of her recent and difficult year-long health negotiation, I was so caught up in caring meticulously for my mother that I confided to her Mesa hairdresser, who is also a good friend, that my overwhelming feeling toward my mother was that I wanted to pick her up like a baby and hold her, rock her, soothe her and energize her back to health.
    When she is feeling physically better, as she is now, a different facet of her dependence glitters. Although she appears, in the morning, to resist my attempts to get her moving, when she is feeling good I can physically feel her feeding off my energy to rouse herself. When she awakens into a "bad" day, though, and I am reluctant to support her lethargy, I can physically feel her blocking my energy output. The day before yesterday involved the strongest blocking I've ever felt from her. It was so strong that I backed off. At that level of strength I assume that her internal drive knows for sure what she needs on that day and it will fight me in any way it can. Today though, although slow, she is not fighting me. She is "leaning" on my energy to get her going.
    Regarding "my audience": I'm aware, from keeping on eye on my stats, that my visitors are few and far between. On those pages which seem to be noticed by bots when someone is searching for medical information (specifically the pages on her meds and her test results), rarely do they get more than a few hits a day. Even my sisters are not regular visitors.
    I'm not discouraged. I feel the pressure of my audience, I hear its questions and comments as I write. I don't yet feel like I'm neglecting them by not going out of my way to publicize this site but I know I have an audience, I know that most of that audience remains unaware of my site and I'm not bothered by this. I would publicize the site more heavily if I had the time to seek out appropriate "Links" pages but I'm also aware, from my brief attempt when I began this site, that other sites that would invite mine have trouble with two aspects: The first being the effusiveness of my site, the second being lack of time to update their "Links" pages. To date I've applied to four appropriate sites. One replied several months ago that they would be "honored" to list me, yet have not updated their links page since. Two others did not respond. One listed me but under an obscure heading. Eldercare and the reporting of it is a dicey exercise for everyone, at this time, especially if one decides to do it as effusively and meticulously as me. Most of the people who might find my site interesting also don't have the time to negotiate all the words. Don't ask me why, but I'm fine with this.
    Mom is breakfasted, dressed and is brushing her teeth in preparation for our day cleaning her room. "Now is the time..."

Maybe it was that I finally accepted Mom's winning yesterday...

2003-09-24T22:31:00.000-07:00

...maybe it was that I finally replenished my supply of Black Cohosh after having been out for 5 days. Whatever the reason, today went well.
I have little time to report tonight so I'll cover today tomorrow for my audience...I say that with a Cheshire grin. My audience. This is a reminder to myself to talk about my audience.
Good night.

I was determined to get Mom moving, today. She was determined to stay in bed.

2003-09-23T23:26:00.000-07:00

    She won.
    I was, as usual, a poor loser.
    When I am a poor loser regarding my mother's life it is because I run scared when I can't get her moving for a few or more days. I ran scared today.
    Everything was fine at first. I allowed her to awaken at her discretion. Fixed breakfast, laid out the day (all the errands that have been stacking up over the last few days, that I've been insisting on holding until I can get her going with me, which have now become urgent), she sounded interested. Then she balked at the bath. I have never seen her more determined than she was today except when she simply refuses to get out of bed. Her color was good, all her numbers were good but she simply, again, is out of the habit of moving much. It only takes her a few days to get out of the habit.
    At first I bribed. Then I teased. Then I cajoled. Then I spat hard reality at her. The less she moves the weaker she becomes, I pointed out, like today, she was already weaving down the hall rather than walking as she moved from dining room to bathroom. I asked her if she was ready to sleep her way into death, if she wanted to do that now. I repeated that, as I've promised, I would protect her. She denied this. I told her we were headed down exactly the same path that caused her ill health this last year. When she didn't respond to this and we were facing off like bull and toreador I finally broke.
    "Okay. To hell with you," I said. "I've got stuff to do to keep our households running until you die. Do what you want. I don't care. I'll be gone for several hours. You're on your own."
    I left. My errands included a personal stop at a friend's home who needed help on her computer but I'd put her off in lieu of the days I had planned on getting my mother out. I spent a few hours there then ran our errands and didn't get back until just before 1800.
    She was up. She called to me tentatively as I came in the door and told me she was worried about me being gone.
    I was brusque with her. I didn't want to repeat everything I'd said this morning about where I went and what I did so I told her that I was sorry she couldn't remember what happened this morning and why I was gone but I wasn't in the mood to repeat it. I took her blood sugar, asked her if she ate, although I could tell she hadn't, nor had she been drinking any fluids. I made dinner, administered her meds, badgered her to drink water all evening, which she did, as I verbally directed her to pick up her glass and take another swallow. Other than that, we left each other alone for most of the evening.
    When she decided to go to bed I apologized to her for my heavy handed treatment. I also told her I was scared that we were headed down exactly the same road that caused the entire last year, which she did not enjoy. She of course, said, "No, nothing's going to happen." But, stuff does happen regardless of what she thinks or says, and it happens to her, and I can only do so much about getting her out and moving.
    I'm getting so tired of battling her to get her moving. Even when a day turns out well and she thanks me for pushing her, even though she tells me, as she did tonight, that she needs me to push her, I'm getting tired of it and the reward of seeing her respond is wearing thin. It is almost too thin, now, to make up for the daily morning battles.

Although the day held early promise...

2003-09-22T22:55:00.000-07:00

...Mom, as it turns out, was almost immovable. I did manage to get her out once after breakfast when we picked up one of her prescriptions. I insisted she go along just to get her dressed and turned out. It was a very short trip, involved almost no walking and Mom went to bed shortly thereafter without deigning acknowledge my argument against napping so soon after arising.
    I decided our trip to Costco and to check out a motel for MCS & BIL could wait until tomorrow. Yesterday some out of town friends visited and, among other much appreciated items and food, left several very soft peaches that needed to be used. I made them into cobbler this afternoon. Since Mom's blood glucose was so good when she awoke ready for lunch and all we were having was cobbler (much to her delight), I thought 425 mg metformin would do the trick. She ended up this evening, before a deli sandwich dinner from yesterday's leftovers, on the high side so I gave her 850 mg metformin. I think the order of those two doses should have been reversed. I'll remember this the next time I treat her to a dessert meal. The metformin works best with the 'forbidden' food.
    I did manage to keep her up from our late lunch time on but she did not want to play any board games, didn't read, didn't pay attention to TV and clearly resented being kept up except when she was eating. Some days just aren't worth getting up for, from my mother's perspective, I guess, and today was one of those days.
    Tomorrow, I've told her, will be a no excuses day unless something happens that requires her hospitalization.
    She laughed.

The Saga of Ellen

2003-09-22T12:33:00.001-07:00

    This is not strictly a Mom & Me circumstance, but a while ago I wrote a story about the "Ellen" in the title of this post. A character in the story named "Sam" is the disguise for my mother. The story is, essentially, true.
    Some of the people who are apt to visit this site, mostly relatives, are very familiar with The Saga of Ellen. There is another development that occurred last night that all who follow this saga will find interesting:
    I was beginning to think that Ellen may have moved out of the neighborhood. Night before last, though, she showed up at the door. She asked why we'd been gone so long, expressed concern about my mother's health and said she hoped I was taking care of her, which I assured her I was. Then she asked for a cigarette, which I politely refused by telling her, "No, Ellen, we've talked about that before," and she left.
    Last night, late, just as I was publishing updates, I heard scuffling at the front screened door to my right by about 7 feet. I looked out and saw what appeared to be a human figure in white moving back and forth right in front of our door.
    I rushed outside and discovered it was Ellen, headed back down our driveway, one of our garbage bags in hand, which she had obviously stolen from our garbage bin right by the front door.
    I yelled at her to bring the garbage back. She offered, over her quickly retreating shoulder, that she would throw it away at her house, as though she was doing me some kind of favor.
    I immediately called the police. An officer who was familiar with Ellen and her Saga in arrived 10 minutes later. We compared histories. I knew some of his, he knew some of ours. I mentioned that I knew she was a difficult case because she'd been picked up several times and, except for prowling, up to now she hasn't broken any laws in her dealings with us, she's just a nuisance. I actually didn't mind, I told him, that some of our garbage was going to be thrown away in her can because, moving back in and all, we've got more garbage than we can handle right now. Until it's on the street curb, though, t is our garbage, she is stealing, and suppose there was sensitive material in the garbage?
    The officer decided that it was time to get serious and bring what law can be brought to bear on her. I was relieved he said this. He suggested as a first step that I swear out a "No Trespassing" citation for a year from the date of issue that bars her from our property. If and when she appears on our property, I would call the police (on the non-emergency number, I noted) and they will dispatch a unit out to "take care of it."
    It sounds like a mini-restraining order. Neither I nor the officer are willing to predict what this will accomplish. He did not indicate whether anyone else in the neighborhood had taken such a step, although I can imagine that the neighbor portrayed as "Daniel" in my story probably has. He was pretty proactive and he and his wife remain in the neighborhood.
    The officer filled me in on a bit more of Ellen's background. She does, indeed, live with her mother and she has and lives with a 14 year old daughter who is aware of her mother's "condition". The head of the household, Ellen's mother, does indeed work, often evening and night shifts. She rations Ellen's cigarettes to two a day for financial reasons. The officer said the mother suggested that Ellen has a highly addictive character and would chain smoke them into financial ruin if she were allowed.
    I told the officer of the length of our history with Ellen (since 1998, I believe), some of the ins and outs, and about the story the entire experience prompted me to write. We were both jovial over the entire experience. The officer, much to my relief after years of ineffective measures, took last night's incident much more seriously than I expected, especially when I told him about having car batteries drained on nights when I'd forget to lock a stray door, she'd discover it, prowl through the car for cigarettes and leave the car door slightly ajar to avoid making noise (which she clearly did not attempt to avoid last night).
    At any rate, The Saga of Ellen continues but, at this point, to my amusement. Some things never change. I have visions of Ellen and her mother dying here, Ellen's daughter, about whom the officer said, "seems smart enough", leaving then coming back throughout her life at critical moments in her mother's and grandmother's lives.
    Hmmmm....

An Administrative Note

2003-09-22T10:00:00.000-07:00

As of this moment Mom has not yet arisen, despite the full retraction of her window shades and one hazy bathroom visit around 0800. As I publish this I'll be awakening her to start our day. We've got a few things to do that involve movement and I'm going to see about getting her to bathe. Should be a busy day.

Check out today's blood glucose numbers...

2003-09-21T22:26:00.003-07:00

...at Ain't She 2 Sweet - 2003. I think I'm finally getting the hang of moderating my mother's blood sugar. I'm feeling pretty good about the at-the-moment decisions I made about medication versus food intake versus what of both I could and couldn't realistically moderate. It all seemed to work. It looks as though yesterday worked, too. Now, if my developing skills work well for me tomorrow I'll feel as though I'm beginning to understand Adult Onset When Elderly Type 2 Diabetes.
I have a few other modulation tricks, one of which I'm using tomorrow morning. In this house I can moderate the amount of light coming directly in her window with the sunrise. On mornings when I feel as though sleeping in would do her no harm the shade hangs lower the previous evening. When I need her to get up 'of her own accord' earlier, the shade is raised a bit. Days always go better when they begin 'of her own accord', so anything that nudges the process is welcome.

Flaking off yesterday apparently did no harm.

2003-09-21T18:51:00.000-07:00

    I'm pleased, too, that it turned out well because I learned some minute lessons about managing blood sugar and b.s. meds (pun unintended but appropriate) on the fly. I was able to apply those lessons today.
    Because her readings were bit higher than normal today, and I knew there was a likelihood that she'd be consuming refined sugar this afternoon, I started her off with a light breakfast of cottage cheese, toast, orange juice, 500 mg metformin, a Detrol and one iron pill (she seemed a bit peaked). Company arrived soon after and she drank water and smoked and watched us put together and raise the unusually complicated shade umbrella in the back. Most of her day was spent sitting and visiting. When groups of us went on property surveys she remained in the domesticated part of the yard. I made sure that she got sick and tired of me reminding her to drink water.
    She measured in normal at lunch and grabbed for a root beer with sugar, as well as a hearty deli lunch with beans, potato salad and a meat and cheese sandwich, so I gave her 1000 mg metformin. If she comes in low normal tonight I'll hold off the metformin and see how she measures in the morning.
    She loved having company and observed (which both of us have noticed many times) how it is that we get more company here than in Mesa. She additionally observed that this house seems to "like company" more than the house in Mesa (I would have to agree with her); "It's inviting in a way that house in Mt. Vernon [Iowa],"
    "Uh, that's Mesa, Mom..."
    "Oh, that's right...in Mesa, what was I saying? Oh, yes, that house in Mesa isn't very inviting. Not like this one."
    "Yes. I know." That's all I said. I don't want to agitate her. She's already testing the waters surrounding getting rid of the Mesa house and moving up here permanently. I'll just let her sit with this for awhile.
    It is true, we do have company planned through the next several weekends. One weekend will probably be pretty hearty, too.
    She's napping, now, with oxygen, but she's "warned" me to let her sleep no later than 1930, 2000 "at the latest." She was quite stiff today (no wonder, considering how much of the last two days she's spent in bed) so I gave her two ibuprofen before she laid down and, amazingly, she took them, so I know she was feeling uncomfortably stiff. She should feel much better at 1930, 2200 "at the latest".

I will, today, be taking numbers.

2003-09-21T08:19:00.000-07:00

    Company is coming, as well, so I may not post them until much later. I'm feeling better, am not overwhelmed that I did not prepare for the company.
    Mom's been up once and went immediately back to bed. She looked good, said she felt, "...O.K., neither good nor bad." We can live with that. She is looking forward to company. So am I. I don't care how the house looks. This is company that not only won't care, they may find the mess intriguing.
    I have no idea what to expect from Mom's numbers today but I'm not worried enough to monitor what she eats, either. I think she'll be fine. I think we both needed a true day of rest from monitoring.

No glucose testing, no med reports (well, maybe one)...

2003-09-20T22:45:00.000-07:00

...and very nearly no journal entry.
    I awoke this morning feeling, well, not good; a combination of physical and emotional not good. I noticed yesterday what I thought was an ear infection. It was some sort of an abscess in my ear that apparently burst last night. That might have led to my extreme lethargy today. Something else was still hitting Mom, I don't know what but I didn't have the energy to battle it. She spent most of the day in bed. I went back to bed after an early, hard morning and decided not to bother with our regular routine except to make sure Mom remained fairly well hydrated and internally bathed in oxygen.
    Since she didn't eat this morning, she refused although she looked good and drank water and coffee, I didn't give her any diabetic medication or anything else. She was up for less than an hour. I went back to bed, fell asleep in a tight fetal position (which is almost unheard of for me) after having only early coffee, which did nothing to enliven me, and re-awoke about 1330 still inordinately sad and physically low but unable to sleep anymore. Mom awoke soon after...I knew she was going to, she had begun to cough...she always coughs just before she awakens.
    So, little by little, as we played best 3 out of 5 Sorry and a very interesting game of Scrabble, she ate and drank: Orange juice, popcorn, V-8 juice (all these preceded by a glipizide). Later in the evening I made us bacon, lettuce and tomato sandwiches, gave her 1000 mg metformin and coaxed her to drink water all evening, topping everything off with a Detrol before she went to bed at 2200.
    This afternoon and evening I revived some, noticed that my ear no longer hurt and that it had been draining and installed a paper towel rack below a kitchen cabinet and cup hooks on the upper shelf of our entertainment center, which was recently christened a dining room hutch.
    Oddly, none of my sadness was about my situation here with my mother. At first it was amorphous, so it was probably catalyzed by the ear infection; then, it was a general tiredness, both physical and emotional, even as I revived. At any rate, I'm lucky that my "situation here with my mother" allows for an occasional day when neither she nor I can hack the medical routine anymore and we both give in to, well, whatever we gave in to today.

I'm still sort of wandering over here...

2003-09-19T22:43:00.000-07:00

...so bear with me as I halt into starting.
    Although Mom awoke at a decent time of her own accord and looked peachy warming her back in the sun at the dining room table (our dining room is more like a large breakfast nook), I got the distinct impression that she was going to beg off our plans, which would entail a fairly busy day today. I can't tell you what my indicator was but I knew that she actually wanted to spend a fair amount of time in bed today.
    I did what I thought was heading her off at the pass. I announced that if she didn't want to go on the short, piddly errands I'd let her stay home through those but going to Costco and the grocery would be invigorating for her, we'd take the oxygen, blah, blah, blah...she's heard it all before and sometimes it's worked. She wasn't having any of it this morning but since I promised her extra bed time after breakfast (more or less, she stayed up for 2 hours after breakfast), she agreed to a long, oxygenated trip, later.
    Between the time Mom finished breakfast and I left alone for what turned out to be all the errands, A[dear]PF and I chatted on the phone a couple of times. She is always interested in how my mother is so I told her that I was trying to rev her up for a decently active afternoon but I could feel her physical resistance to anything but a day of sleep and she'd already had more than a few laconic days. My friend cut in and told me about one of her friends, a year or so over 90, who always complains that it takes her a month to acclimate to Prescott no matter how long she's been gone. During that month she spends "sometimes whole days and nights" sleeping.
    I rethought today's strategy. If she was going to be sleeping and I couldn't get her to do anything else and, one way or another, would give in to her, at least I could see to it that she was bathing herself in oxygen throughout the entire day. That should give her a fine start on tomorrow.
    When I left early in the afternoon Mom had been in bed for 30 minutes or so. I had told her I'd be back after the few short errands to see if she wanted to go to the grocery with me. Although she acknowledged what I'd said, her eyes had begun to roll blissfully back into her head. I replayed the scenario as I drove from errand to errand and finally decided to give her a treat and let her sleep. I knew I'd have to control for dehydration tonight and that wouldn't be fun for her, but I could feel, this morning, her need for sleep and after my discussions with A[dear]PF, I decided a day of morphic luxury for Mom was all right.
    She has been mentioning, as well, lately, that she wanted something sweet. I've been pretty good at gently dissuading her, since her blood glucose has been spiking without the benefit of refined sugar, thank you. But today I decided to get her some cheesecake and spring it on her if her blood sugar wasn't too far out of whack this evening, considering that she wouldn't have the benefit of 500 mg metformin in the afternoon. I needn't have worried. Her blood sugar was 71. So I gave her a second 500 mg metformin at dinner and a third two hours later during dessert. I expect her to read good in the morning. Although she'll be slow to move I think we'll manage to get out on our "adventure", the one we put off doing today.

A member of the book club told me, last night...

2003-09-19T22:37:00.000-07:00

...that her mother, this last year, made a significant and unexpected recovery to former competence at 91. She said that around December of last year her family thought, "this is it," then her mother not only made a spectacular recovery (from what, no one is sure) but has been raised from assisted living at her living facility to independent living.
    I'm glad she told me this. I'm always pleased to hear when Ancient Ones get second winds. No one expects them to, but they do anyway. I don't think my mother will every qualify, again, for any kind of "independent living"; she's 'made the decision' (and, I believe it was a decision, and it was not a bad decision) that she does not want to deal with a lot of life stuff anymore, including paying bills, etc. That's okay with me. I can do all that and, in some ways, I've learned things I'd never have learned otherwise.
    Of course I don't know exactly the definition of "independent living" at a facility for the elderly and infirm. So, I don't know, maybe it's something Mom would be able to do.
    At any rate, this situation, me with her, seems to be working. I'm glad. This way all of us in the family have a reliable, detailed, worry free source of information on my mother. If I was unable to do this for my mother I would wish I had a sibling who could.
    Tomorrow we are going on what both my oldest sister and my mother independently referred to as an "adventure". Mom and I are going to check out at least one hotel for MCS/BIL, maybe more. I mentioned to MCS, when she referred to the reconnaissance mission as an "adventure" that I actually enjoyed the adventurous sense that surrounds life when you're living it closely with an Ancient One. She confirmed that she is also experiencing this with her grandchildren, for whom she cares three days a week. Lately, flowers, she said, have been an adventure. I agreed that flowers have wonderful adventure possibilities for both New Ones and Ancient Ones.
    "Yes," she said, "[Her grandson] pulls the petals off and hands me what's left. [Her granddaughter] eats them and hands me what's left."
    Somehow, I identify with this, living here with Mom.

I think it will be an at home day...

2003-09-19T12:30:00.001-07:00

...although previously I thought it would be a 'going to Mesa to partially close the house down there' day. I believe Mom when she says she's physically tired, although her later blood sugar readings will tell whether it's her body that's taking some much deserved rest or her mind. Her blood sugar usually remains in control if her body is resting. If her mind is junking out her blood sugar goes up. I think it's okay for the latter to sometimes happen.
    This morning she remembered last night's book club meeting. She remarked several times after we arrived home how much she enjoyed it. This morning it was the first thing on her mind.
    I'll probably be spending much time on the internet tweaking the site. I'm beefing up the Essays section, little by little, in both quantity and quality (and eye candy).
    I'm sure I'll have more to say...
    ...later.

Am I becoming blood glucose obsessed again?

2003-09-19T00:33:00.000-07:00

    Yeah, it would be fair to say I am. Because of the quirky way we ate today I had to know what her level was when we arrived home from the book club: 100.
    I wasn't sure, after the last few days, what to expect. I was hoping that my medication modifications would help. However, today (Thursday), well, she had a normal early breakfast, nachos for a late lunch and I never found a time when she had been fasting for at least two hours. I read a few months ago that glipizide works best when administered in a fasting state; second best when administered at least two hours after having eaten and a half hour before eating again. The only part of this regimen that happened today was the half hour before eating part. She snacked on popcorn and V-8 juice before we went to the book club meeting then ate a nice little meal of cheese, crackers, a berry strudel-like creation and a slice of vanilla/chocolate cheesecake, washing it all down with "the pink wine". And, her blood sugar was 100 at almost 10 this evening.
    I learned something, tonight. I'm not sure what, but I feel grounded in how I'm approaching her blood sugar.
    Time for bed.
    Later.

Days like today...

2003-09-18T17:35:00.000-07:00

...make me wonder how much we as a species really know about life blood glucose histories. She's running classically high today in everything including her vitality. I can't argue with success, although I have no idea to whom or what the success is owed.
    Lately I've wondered what her blood sugar used to run when she was teaching, we were all in school and she'd pop caramels all day then bolster herself with a dish of ice cream at 2300 or midnight. Do we really know, I wonder, what's normal for blood glucose across the board? Is it possible to run high or at least spikey all your life and avoid the degenerations typical of diabetics, all of them linked through the certainty of kidney disease, the classic version of which my mother does not have?
    Although her day has not included much exercise, she's been meeting old friends and is due to reunite with others tonight. I've been telling her that I'd prefer she use the oxygen tonight but, you know, maybe we'll wait. She used oxygen throughout her nap and she is pink (just this side of an unusually iron rich red) and alert. She looks good. Her hair stylist here loves to experiment on Mom and she did so today, in celebration of our reunion, I think.
    Walking into the salon was like watching a debugged program kick in. Mom swore before this morning that she didn't remember the salon. We drove by it yesterday but it didn't fire across any synapses. Today though, when she walked in, everything snapped into place and she trotted right over to the sitting area. I'm sure she recognized her hair stylist. We were all delighted to be back together. My mother even countered my version of events since a year ago today, the day we left for Mesa because her feet were swelling unnaturally. The day this all began.
    Time to get ready to go to the book club meeting.
    thankyou

I am posting, immediately, a very curious blood glucose day...

2003-09-17T23:44:00.000-07:00

...in that it is looking frighteningly familiar. I'll add commentary, here, later.

She was...

2003-09-17T00:30:00.000-07:00

...very hard to move, this morning (that's Tuesday morning). When I decided to awaken her at 0915 and take her with me on all errands she was sleeping what I think of as a death sleep or being comatose. I felt bad but I also knew some of this was due to her unmanageable blood sugar spike yesterday which I thought I might have treated.
    No such luck. Although she was game for breakfast and was up an hour she begged off the first errand, getting purified water and picking up a few fresh salad vegetables at the grocery.
    I routed her out of bed again when I returned about an hour later. I decided that she would use the portable oxygen on our trip, including at Costco. She balked, saying that she didn't want anyone to think she needed it. I insisted, explaining once again how it is not simply a lifelong nuisance, it is therapy which she can use in a way to strengthen her lungs, her body, and thus enjoy life more. As I spouted this propaganda she liked it.
    At Costco, luckily, there were two robust elders on portable oxygen. I did not go out of my way to point them out to her but I saw her looking at them. I mentioned them later. She did not remember seeing them. She was, however, completely comfortable with the oxygen during our trek through Costco.
    Her stamina during the Costco visit was remarkable enough so that she commented on it. She had no desire to rest and wheeled about from sampling kiosk to sampling kiosk. We needed only a few things but we did the store. Traffic in the store was unusually light, which was good. She decided, on her own, to peruse the Christmas section, including the edibles, although she did not reach for any.
    When I got the 214 reading prior to lunch, after she'd spent the entire morning in bed except for the two hours involving the Costco trip, I hustled her. Lunch was light, and one of her favorites: cottage cheese with lots of black pepper, 12 oz V-8 juice and about half a bag of popcorn. Her snacking at Costco didn't create a problem, as she came in one point above normal just before dinner.
    I administered metformin at each meal today. I've also been spending the day preparing her for our busy day tomorrow which will include her first appointment with her Prescott hair stylist in a year and a book club meeting tomorrow night. She was energetic this evening and is looking forward to everything.
    So am I.

You can stay up here if you want to," she said tonight,

2003-09-15T22:25:00.000-07:00

"it's very nice here and I've enjoyed it but I've got to get home. I think I'll go back tomorrow. You know, I've got one kitty there I've got to take care of." Her voice was matter of fact and intimate.
    I laughed. I should explain something here. When I say I laugh (in a manner which can be construed as 'at her' and, truthfully, it usually isn't 'with her'), to which I often admit when telling about one of my mother's creative mental episodes, it is always joyous laughter. I love it when my mother takes me on an unexpected trip. Once she solicits my involvement, the trip usually shortens considerably, depending on how important it is to enjoy the ride or correct her, but my laughter, when she launches us, is always of the felicitously unexpected variety, and loaded with, well, joy. Yes. Joy.
    Anyway, I laughed. "Mom," I said, "you are home, for the time being. And both your kitties are here. So, you can relax and enjoy yourself."
    She looked startled. She scanned the corners of the room on cat reconnaissance. "But, I haven't seen them. I don't believe either of them is here."
    "They're still hiding out from us moving the furniture, Mom, but they're here. The Big Girl is underneath the couch, see?"
    "Oh. Yeaup. There she is. That means The Little Girl is alone, then."
    In sauntered The Little Girl, on cue. "No, she's right here."
    Mom looked surprised, almost offended. "Well, when did you bring them up!?!"
    "You and I brought them up Saturday, Mom."
    "Well, do you think they like it?"
    "Oh, yeah! We've been talking for three days about how much they love it up here."
    "Wait a minute. This is Sunday, isn't it?!? Because if it's Monday I've definitely got to get home tomorrow. You can stay here. That's no problem."
    "Mom, it's okay. You're where you're supposed to be. And you're not going anywhere anymore without me."
    She looked at me as though this was new information. Relief swept over her face. "Good," she said. "I don't think I want to live alone anymore."
    "Well good, because I don't want you to, so I'll stay with you."
    I was going to let it drop there but I was a touch discombobulated and I had to know: Did she remember all the serious talks we've had over the last three days about getting rid of the Mesa place and remodeling this to our specifications? I reminded her and asked her if she remembered.
    She thought. Hard. Searched. "Welllll, noooo, but," her voice brightened, "it sounds like a good idea. Let's consider that."
    Whew. That was close.
    Later, I muted the television during a spasm of commercials and told her that if she was still confused we could talk about where we are, where we came from, where we'll be tomorrow and why.
    No, she said, she'll be fine. She just needs to adjust.
    I trust her sense of this. I think she's right.

    No iron today. Her lips are beginning to look like a vampire's after a feeding. I took her off it this morning. She's had two Detrol today but this evening when I rubbed her legs [to my continued delight, she always acts as though me rubbing her legs is an entirely new concept and a great one, not a months' long habit in which we've indulged] I noticed that she was beginning to retain all the water I pushed on her today.
    I hardly overworked her! I did notice that we definitely need to get her eyes checked at the Veteran's Clinic. She had trouble seeing obvious dirt on the floor when she was sweeping. I am aware, too, that she is still compromised by this thin atmosphere. But we've had more than some spectacular days in a row so I'm not surprised that she dragged early.
    We didn't go anyplace today. We may make our first trip back to Mesa to partially close on Thursday. She's slowing down. So, as it turns out, am I. I still have loads more energy than she but I go to bed physically exhausted at night. It's a good feeling. And waking up here is like waking up in heaven. Mom has mentioned this, too. Of course, she's been up and down through the nights so her final wake-up every morning has been late. But Wednesday is a hair day and I think she'll be ready for a scheduled day, again.
    She's doing well. Our household is doing well. I'm doing well.
    thankyou

I laid down for a "short" nap at 1945....

2003-09-14T22:58:00.000-07:00

...and awoke at 2130 just as Mom was getting ready for bed. I guess I was exhausted. As well, my feet have been hurting from wearing a pair of shoes that don't fit right. I left the others in Mesa.
Mom wasn't hungry when I laid down. She awoke about 1900. I put out some popcorn to help regulate her and give her the sense of thirst then set about having her drink water.
When I awoke I discovered that Mom had been munching popcorn all evening. She claimed not to be hungry. I took her blood sugar and decided to administer her regular dose of glipizide (and one Detrol), even though she wasn't taking it as per regulation. I suspect I'll have something new to learn about glipizide from Mom's first blood glucose reading, tomorrow.

I want to mention this for my own reference...

2003-09-14T17:49:00.000-07:00

...as in a gardener's diary:
    She was exceedingly hard to get going this morning. I guess this is going to be a permanent circumstance.
    She also had a shitting accident. No big deal...it was at home. Which reminds me, I wanted to mention: About a week ago, a day or so after eating something very hot/spicy, I had a shitting accident when I sneezed one morning. The only way I realized it is that suddenly my cheeks felt delightfully warm (I was sitting down when it happened). So now I know how it is Mom can have a shitting accident without realizing it. I'd wondered about this.
    Ask and ye shall receive.

Yes. Well. So, the metformin works...

2003-09-14T17:41:00.000-07:00

...with circumspection and reservation. It worked this morning. This afternoon, as we checked out of Target, to which she went with me, without oxygen, at her insistence, after a fairly lengthy trip through the grocery she grabbed a Hershey's with Almonds candy bar from the literal eye candy displayed as one steps up to the register. I okayed the purchase, telling her that she would eat cottage cheese and have a 12 oz. can of V-8 juice first. I also gave her another 425 mg metformin. We'll see what happens this evening.
    She just laid down for a nap. I put her on oxygen. She said "Good night." Freudian slip. I brought it to her attention, laughing. Then I told her that we'd probably be having dinner very late tonight.
    "I might sleep right through till morning."
    "If you do, that's fine. I imagine you'll get up, here and there. You might want popcorn, or something. I'll be up pretty late I think, just shaking it all out. I'll push water on you if I'm up when you get up."
    "I'm sure you will." Said with a loving edge.
    Today while we were driving from place to place I found myself making everything we passed, talked about, looked at, etc., an object lesson, the object being her improving health. In the middle of some inane propaganda piece about how going to Wal-Mart would be "better for her health" than Target, I suddenly realized what I was doing. "Don't you get sick of me constantly ragging on your health, Mom?" I laughed ironically and a little self-deprecatingly.
    "I'm sorry, I didn't understand..."
    I was practically yelling in her ear and, as MPS once pointed out not too long ago, I wasn't born with "an indoor voice" so I knew she'd gotten hung up on a word, probably "ragging". "Bitching at you, nagging you, making everything health related. Don't you hate that?"
    "It's not my favorite way to spend an afternoon." Always the diplomat.
    We were both silent.
    "Well," she finally said, "aren't you going to say something like, 'I won't do it again?'" She was just this loving side of sarcasm.
    I thought about it. "No, because I probably will do it again. I'll try not to do it again today."
    She didn't say anything.
    That's why I said nothing about the candy bar; just dosed her with metformin.
    For those of you who have known my mother's extreme, boulder-like lethargy for the past two and a half years, you would have been truly amazed to see her today. In Prescott. Without oxygen. I'm sorry you weren't here. We would have had a good time.

    Before she closed her eyes for her nap I asked her if she hurt anywhere.
    She focused on me, surprised. "No," she said. "Why, do I have a bruise?"
    "No, I just wondered if you were aching from exercise, if you might want an ibuprofen."
    She wrinkled her nose. "Nah, I don't take that stuff." She's nearly telling the truth. About once every six months or so I find a reason to push one on her, with great difficulty and many campaign promises.
    "Okay. I was just wondering."
    I think we may put off a trip to the Valley to partially close until Tuesday, or Thursday, which I was planning to be our second trip of this week and final closing trip. I think we'll take it slower. I mentioned to her in the car today that I thought we should spend some time at the Square tomorrow. Maybe bring a game and play. Do a little walking and wheeling. She thought that was a great idea. We'll take it a plan at a time.

I think Mom is recovering from the move...

2003-09-14T13:49:00.000-07:00

...which isn't quite over, but at least we've relocated base camp. Although she has had more oxygen in the last 36 hours than she has for a long time, the rest of her body needs to adjust and her mind needs to wrap itself a little more firmly around being up here.
   I was a little surprised at her blood glucose reading this morning (just 5 minutes short of noon). I think, if nothing else, it proves that without glipizide, metformin does very little for my mother. She got her glipizide this morning though, and an iron pill and a Detrol (although she's quite dehydrated, but I'm working on that). She's looking good, just stunned tired.
    When I awoke at 0515 (I am irrepressible up here) I noticed it looked as though she had been up a few times in the middle of the night (we went to bed at 2330) hunting for cigarettes. She didn't find any; I can tell because the ashtrays were clean. The reason I know she was up twice is that she filled two separate glasses with water. They were sitting side by side on the table this morning. The first thing she usually does in the middle of the night is fill a glass with water at the kitchen sink then she proceeds to her chair.
    I'm not going to be hard on her today but I'm going to get her moving a little, although she's decided not to take a bath, "yet." We need a few minor necessities so I'm taking her to the grocery. It won't be a long trip and we'll take it slow but I want to get her in the habit of moving a little every day.
    She hasn't mentioned, this morning, any of her fancy talk from yesterday evening about moving up here permanently. We'll see how it goes. I noticed at breakfast, she was breathing in those short, hard sucks, sounding almost like the puff of the OCD in the car yesterday. I put her back on oxygen after she awoke (she took herself off before she stood away from the bed) until she remembered that she smokes and found some cigarettes in her purse (thank god she didn't find them last night). I'm sure she'll need to use oxygen more frequently, up here.

Busy and wonderful day!

2003-09-13T22:52:00.000-07:00

    She's done so well today! Very alert, energetic (for her), no nap, oxygen all the way up. This time I used the excuse that there is no smoking when the cats are in the car, which is true, then added, "...so, why don't you go ahead and wear the oxygen all the way up?" I noticed something interesting. Her breathing was a bit less quick than it was on Wednesday. I also noticed, as the puffs of the OCD mimicked her breathing (it delivers oxygen only when the user breathes in, thus, it is an Oxygen Conserving Device), how slow and deep my breathing is in comparison to hers. I mean, hers couldn't be very deep if she is breathing as fast as she is. But today she breathed slower, about half as fast as Wednesday, which, while her breathing was still about an intake a second at times and not necessarily dependent on altitude, her breathing also seemed more relaxed. Maybe she's just getting used to breathing oxygen during the day. Good, I say.
    That's right. No nap, although she slept a good twelve hours (give or take a half hour, here and there, to eat cheese) last night. I know the oxygen is, at this time, largely responsible for this. That's okay with me. I intend to take advantage of the opportunity this will offer to expand her lung capacity.
    She is, again, as was once usual and is, in some ways, unusual this time, in love with this house in Prescott and the property, again. She's talking about letting go of the mobile home in Mesa. She asked me tonight how I'd feel about that.
    I laughed. "I'd be deliriously happy!"
    "I thought you might say that," her eyes focused, her eyebrows cocked as though she'd just revealed she'd learned something new and valuable about me that even I might not know.
    I love it when old age allows people to discover the people in their lives anew.
    She asked about the friends I have in Mesa.
    I told her they are mobile and have proven so many times.
    She asked, I think to test her own reactions, which she wasn't revealing, to these 'new' thoughts, what I'd miss.
    I was honest with her. I'll miss our mechanics. I'll miss her hair dresser and the community of women to which we belong by virtue of her being a regular client. I'll miss the orange and grapefruit trees. I will. "But," I added, "I'm not sure any of those are worth continuing to bleed ourselves by holding on to that mobile home."
    "I think you might be right," she said. Not, please note, "You may be right," which means "You are not right and you're being silly to boot, but I'm too genteel to point it out and, anyway, I'm sure you know you're being silly," but, "I think you might be right." That means she's considering the efficacy and truth of an idea from her typically optimistic perspective.
    Not that we wouldn't miss the Mesa place. But it would be so much more convenient to simply rent a room for a night to visit, then return to Prescott.
    So many possibilities. Pinch me, I feel as though I'm dreaming the beginning of my mother's ninth life, or one of the later ones, anyway.

Once I got her going...

2003-09-12T20:57:00.000-07:00

...by pushing and pushing, but nothing unusual, she held up pretty well. We took in a short trip to Costco. Of her own accord she latched onto a shopping cart in the parking lot to wheel into the store. I usually take her firmly by her right arm and we walk at her pace wherever we're going until we get to the cart section at the store. I cautioned her, before she touched the handle of the cart, that it may be warm, she may want to wait until we reached the ones in the shade about half a Costco parking lot away.
    She verbally slapped me away. "I can get there on my own," she insisted, "I walk better when I push something."
    Exactly what I say to her every time we go some place through which she can negotiate from the business end of a cart.
    Something I haven't mentioned, before: Since it's been over two years since she's driven shopping carts, she is comically unaware of where the cart's hind wheels are going. She hangs herself up on shelving corners on the ends of aisles. I try to perform reconnaissance for her but that doesn't always work. She is so funny, affectionately amusing type of funny. On the one hand, she is super careful of other people in stores including, as you'll remember, helping our queue mates unload their carts. [Every time she does this, I have the urge to say, jokingly, "Take inventory before you leave the store, you gotta watch out for this woman!"]
    We ate a lunch of polish sausage and sauerkraut. She downed, gratefully, a full glass of that "light" lemonade that she likes.
    She announced matter-of-factly, on our way home at about 1430, that she was suddenly tired. We were going to go to Target for some cheap essentials but from the way she told me she was tired I knew it was time to take her home.
    I still had another two hours of shopping and business to do. When I returned she was still asleep but light enough so that the closing of the door awoke her. She's still up now, at 2034, watching Animal Planet, drinking coffee, pointing stuff out to me as I type on the computer behind her.
    I like it this way. It's been a long time.
    Much earlier today during breakfast, which occurred appropriately early for her, she asked me in dead seriousness, "What should we do about this place, here?"
    I sighed. I decided not to hide my weariness of the subject. I 'reminded' her [as, I don't think there is such as thing as 'reminding' her, anymore] that we beat that poor horse half to death yesterday afternoon. Before she had a chance to say that she didn't remember I said, "I know you don't remember, but I don't want to think about that today, it's not necessary. So, we're not going to talk about it."
    She could tell I had just about had it. She was gracious enough to back down but warned me that the subject would come up again. Of course it will. At a time when I have the energy to deal with it. Again.
    Tomorrow will be the heavy duty switch of cars from 0430 to, well, I'll probably get back by shuttle, at 1030. Then we'll pack up the essentials I didn't pack tonight or in the morning (the computer will go up before sunrise), the cats, the Mom, do a mini-close on the house (turn off water, water heater, boost a/c thermostat [we'll be back and forth for probably a week so I'm not turning off the power until sometime next week]) and head up the mountain. I don't expect to get in more than one blood glucose reading, maybe in the late morning, maybe at night. She'll get her medicine but flexibly, and, well, we're moving and if you know her you know that she will be excited; slow, due to being ancient, but excited. I'm expecting a good day.
    Later, probably much later.

Forgot to mention...

2003-09-12T07:07:00.000-07:00

...more for my own reference [in case you're wondering, I do not reread my stuff here hardly at all] and as a reminder to post something, soon, in the Mom's Medications page: I have been giving her 3 Detrol every two days. It helps her retain water not unnaturally. I have to closely monitor her intake, though. I have had to rigorously massage her into a water shed once since I began upping her Detrol.

Catching up: Blood Glucose readings through yesterday...

2003-09-12T06:57:00.003-07:00

...have been updated. Go to Ain't She 2 Sweet - 2003. Nothing surprising to me, although I wonder how many of her ups and downs have to do with the traveling.
    The last few days have reminded me that she has a 'travelin' [wo]man' gene. It continues to kick in. We've talked, over the last 48 hours, about moving to Australia. Or New Zealand. It was only half fantasy. I've been wondering lately how much stamina my mother has recovered; or, perhaps, better put, how much stamina she still has, considering her survival of the last 2 - 2½ years.
    Maybe 5 days ago Driving Miss Daisy aired. I have never seen the entire movie, although I know, since its release, my mother has seen it several times, once in a theater. She didn't remember seeing it previously when we watched it this airing but she enjoyed it. Once again, I did not see all of it.
    I was struck by how much more emotionally melodic the film seems to me now that I have been companioning my mother through her aging. What seemed previously to be a smart, sweet film, now surprises me with its intimate, unadorned, almost self-conscious portrayal of old age. As time advanced through the film I was able to fill in the gaps between years. I remember wondering, as the scene wherein Miss Daisy literally relives her years as a teacher (my mother was a teacher almost her entire life; it was her calling, I would say) how many years prior Miss Daisy might have begun to wear paper underwear.
    Today? Hmmm...hair day, buy some sweater shirts at Costco for her, probably buy her a polish sausage with sauerkraut and a 'light' (I'm not sure if that means no sugar...it tastes surprisingly good for an artificially sweetened drink) lemonade, both of which she loves. I should probably pack some boxes, ready the computer for early shipment tomorrow. I've got calls to make, calls to answer...I've put off making another delivery run until, maybe, Sunday.
    We've got a ton of oxygen and a second concentrator which will help us negotiate the curious layout of the Prescott house. I'm a little overwhelmed with having to transport all that up. I've decided to leave the house down here 'on', maybe through next week. Mom and I will make some delivery runs from our base in Prescott as we begin our life there.
    I remarked to MD[dear]CFs yesterday afternoon that it didn't seem like we were making the startling break that's usual when we move. I guess we aren't, since we'll be closing the Prescott house back down and returning to Mesa in November.
    I gave her 850 mgs metformin last night. I've also been giving her an iron tablet twice a day since last Saturday on a hunch, just in case. I don't know whether I've noticed anything or not. Sometimes I think, in regard to my mother, I am developing some of that 'second sight' technique my mother used to teach pilots in WWII: recognizing and acting on what is recognized before conscious awareness. I am pleased about this.
    I am purposely slowing us down. It feels right to me.

Can you give me a few more minutes?

2003-09-11T23:49:00.000-07:00

    Not that I've explicitly asked anyone that today but I've been operating from that implicit question. Busy. And calm. And running late all day. Around Mom. She spent most of the day, no, excuse me, all of the day at home. I think she may have spent less time sleeping than she believes because when I finally arrived home with dinner she was awake, had eaten through almost a bag of popcorn, the TV was on, loud, so she had actually been trying to listen to it rather than use it as background noise for a nap. She gave me two different stories about whether she'd spent most of the day sleeping but it wasn't, and isn't, important.
    Her spirit is good. So is mine. I am, also, tired. Hopefully just tonight. We are going to be transporting less stuff before the move than I thought. I think it is important that tomorrow we use Mom's last hair appointment with her usual hair dresser as a pivot point around which the entire day is filled with some mild and stimulating activity, conversation, etc.
    I am running on nervous energy now, reviewing everything. Mom has been a bit foggy since Prescott. I'm not sure whether that's shell shock or, I don't know. Whatever, I'm giving her some supplemental iron right now. I don't think it will hurt her.
    Her blood sugar is another matter. I've been giving her almost regular doses of metformin but usually only a well timed once a day, if that. I modulate the dosage depending on her previous reading. I took one reading recently, although I've packed the glucometer (I may get it out before we move and record some of the readings, I may not) of 225, I think. I have no idea why. But spikes like that deserve 1000 mgs. A spike of 156, I believe, which I got today, gets 850 mgs. She stayed up all evening and we talked, watched TV, I wandered around putting things in boxes, finding things, losing things, until we finally stopped and stared at the set for awhile.
    In an effort to make the transition smooth and inviting I've already scheduled her first hair appointment in Prescott for Wednesday, September 17th. Oh! I just realized! Perfect timing for the book club meeting! Great! Our Prescott hair specialist (she really is more of a hair sculptor than a beautician) is excited about seeing both of us again, I'm excited about seeing her and my mother is having bouts of remembering who her hair sculptor is and wondering how she's doing. "I'd like to see her again," she said today.
    I will probably create a mood ring of a recording here of various periods throughout the last few and next few days that particularly strike me and why. But that will come later, in the oxygen-thin digestion of moving slow down.

Crazy busy and exhilarating.

2003-09-11T11:15:00.000-07:00

    That's how it is now. I haven't found time to even post blood glucose results and they went a little crazy yesterday, another adjustment was necessar, and we're back to normal (for Mom) again. Moving continues. It looks as though it will continue for a few days to a week from our base in Prescott as of Saturday but that's okay, I'm not complaining.
    Just to let you know, Mom had a great time in Prescott yesterday. So did I. We used the portable oxygen on and off with out a hitch. Yes, she still had smoking breaks, but her overall health is so good that she went the entire day without a nap and stayed up until almost midnight last night. She is, as usual, more than grateful that we have "that house up there", is looking forward to the work we plan to do on it once we negotiate a home equity loan and said this morning, "You know, I think I'm going to enjoy being in Prescott, again. I'm looking forward to moving up there. I wonder if we should consider selling this house down here." For those of you who know her, the last sentence is a sentence I never thought I'd hear from her!
    More, much more later, including updates on her blood glucose readings, much later, probably beginning Sunday.
    I'm stoked. Mom is stoked. The Girls are still insisting, as always, that, rather than endure the car trip, they'll stay down here, take jobs and keep the house open. So everything is going well, better than I expected considering how the use of the portable oxygen changed the tone of what could have been a draggy trip to Prescott. As well, everything is operating as it should at our house in Prescott, including the water heater and the refrigerator. My fears were completely unfounded. I'm hopeful and excited. So is Mom. What a miracle!
    Later.

A short note from a very tired journalist.

2003-09-09T22:56:00.000-07:00

    What a day. We only got in one blood glucose reading, the morning one, and it was on the high side, in the 140's, I think. I can barely think about everything else that went on and some of the conclusions I reached, which I'm still trying to digest and to which I am still trying to adjust. I'll explain more later, probably after we are up in Prescott on Saturday.
    Tomorrow is our first delivery trip, although my day today was so completely sidetracked that I'm not sure how much stuff we'll actually transfer tomorrow. We need to go, though, and make sure the Prescott part of the mail switch took place and, I guess, make sure the place is still standing. I have a funny feeling we're going to be greeted with either a water heater or a refrigerator that has stopped functioning, but we'll see tomorrow.
    More later, in fits and starts. This move is going to be a challenge, but my shoulder is already to the wheel and aching a bit. Once again, wish me luck and send me energy, I'm still in need of both and in need of more. Thank you.

A storm, that I thought would bypass us,...

2003-09-08T23:48:00.000-07:00

...as have so many other summer storms this year, is going to hit us tomorrow throughout the entire state so we won't be taking our first delivery trip tomorrow, but Wednesday. Too many crosswind channels on I-17 and State Route 69 to worry about for me to try to attempt it. Even if we end up taking a delivery trip or two after we relocate on Saturday I'd rather do that then end up on the floor of a wash or canyon tomorrow, or fishtailed into an immobile edifice.

We are on our way to Prescott...

2003-09-08T17:04:00.000-07:00

...although the procedure takes a good week. We began in earnest late last week. Our first Absolutely Moved Day, when The Girls (our cats) come with us, will be Saturday. In the meantime I may not be posting much except for blood glucose readings...it's been very busy since we finally, this year, focused on Prescott.
    I'm not sure why Mom's blood glucose was so high this morning. I did notice, this weekend, when I was looking for a full bag of croutons I knew we had that only a few crumbs were left in the bottom of the bag so it's possible that she's waking in the middle of the night and eating, which is her occasional habit. There's not much I can do about this and I'm not sure I'd want to but if it becomes a more than occasional habit I'll probably try to control her blood glucose with 850 mg metformin at night.
    Otherwise, the 192 afternoon spike on Saturday was my fault. Mom arose at exactly the time I received a surprise (it was a Saturday, after all) business call regarding our refinancing that I was extremely reluctant to put off. So, I ushered her through our morning routine while I continued with what turned out to be a very long call. As a result I not only forgot to take her blood glucose reading I also forgot to administer her dose of glipizide. That taught me a lesson about answering the phone when Mom has just arisen. Things start hot and heavy as soon as she wakes up, so it might be best from now on if I let voice mail get the phone during our morning routine, as I typically do if she and I are involved in giving her a bath or some other maintenance activity that requires both hands and/or strict attention.
    Sunday, however, was pretty typical glucose wise. This morning she was a bit on the high side but, after her hair appointment we had some shopping to do so she got some walking in and it snapped back to normal at lunch. She's already requested a junk food dinner (we haven't had junk food for awhile), but, depending on what her reading is, I may not bother with metformin tonight and see "how it all comes out in the wash" tomorrow morning. As well, we're making delivery trips to Prescott tomorrow and Wednesday which will involve some more exercise for her so I'm not too worried about what her blood sugar will do over the next few days.
    We will be experimenting with the oxygen in the car tomorrow so, as our oxygen guy suggested, "I can get the practice". It'll be interesting. She won't be able to smoke on the way up. I've also banned smoking over the last few years when we transfer the cats because one of our cats suffers from motion sickness. I remember, when I was a kid before I could drive and, thus, suffered from motion sickness almost every time I rode in a car that my parents' cigarette smoke worsened my misery. Mom has been cooperative with not smoking when the cats are in the car. I hope she'll also be cooperative (with some reminders, I'm sure) with the oxygen/smoking ban.
    She isn't as excited as I am about being able to spend a couple of months in Prescott this year. I'm working on her response to Prescott. It is completely emotional and unreasonable, especially considering that she really wanted the house when we bought it; so much that, when I tried to talk her out of it, reminding her of her innate emotional problem with Prescott and the fact that Prescott was not my choice for a summer place, she refused to listen to me. Curiously, I was the one who made the adjustment and now love Prescott. She hasn't yet. I am, though, being stubborn about insisting that she once again try, in part, now, because from a health standpoint Prescott has a lot more to offer her than Mesa. There are plenty of places to walk and exercise for free, lots of outdoor people-watching places that don't involve having to be in stores, my support network up there loves my mother and is completely amenable to me bringing her along to almost any place or function I attend (although, to be fair, this is also true of my support network down here) and the Veteran's Hospital is only 5 miles from our house. Up until this period of my adventure with my mother I have allowed her to stay at home when she didn't want to go someplace with me, both in Prescott and here. That, unfortunately, worked against her general health and, as well, against her emotional perception of Prescott. Now, because she has to come with me at least for awhile and we have the tools, both oxygen and a wheelchair, if needed, we're going to do it my way. I'm hoping that she'll come to see Prescott in a different light.
    Wish me luck. More, later, as time allows between delivery trips, "final" visits with people down here and business we must handle before moving.

It's been a very, very full weekend.

2003-09-07T23:32:00.000-07:00

I'll post more tomorrow, hopefully, if life settles down, a bit.

It seems to be working.

2003-09-06T10:14:00.000-07:00

Mom always makes a bathroom run early in the morning a few hours before she awakens. I'm usually up and here (if I'm not here I'm on my morning walk) when her initial morning-up-and-down occurs and usually have her change her pad before heading back for bed. This morning I am pleased to report that giving her two Detrol yesterday, one in the morning and one in the evening, and only occasionally monitoring her water intake seems to work for both of us. She developed a little noticeable dehydration last night and I had her drink an extra 10 oz. glass of water but other than that I left her alone. She did not have unusual swelling in her feet, legs and belly last night. She did not experience unusual water shedding while she slept. Her dehydration level this morning before heading back for bed was normal. I think we've finally hit on a solution to her hydration problem.
As I observe old age happening to my mother a myriad of mental videos flick through my mind, miscellaneous tableaux from a jumble of sources:

The societal habit of some historically earlier societies of allowing the encumbrances of old age to inevitably slip the Ancient One further and further from the community, both socially and physically, until death overtakes the one left behind;
Images, both recent and past, of older people desperately seeking ways to circumvent the 'ravages' of old age in a variety of ways;
Images that define how our bodies and minds might evolve to handle the certainty of longer, healthier lives;
Speculations about what hands-on evolutionary tactics we will consciously devise to, literally, change the face of old age;
Considerations of our efforts to extend the timeline of life, change our expectations of aging and possibly eradicate death.

    It hasn't been long since I thought that staving off death was a tricky decision when it comes to old age or a variety of chronic illnesses that relentlessly and successively reduce one's quality of life until death is inevitable. I've wondered about the wisdom of 'artificially' handling conditions that would naturally promote death, three of these being loss of appetite, loss of thirst and the tendency of the body to flush fluid much more quickly than when one is younger. It has seemed to me the unquestionable 'wisdom' of Nature that these conditions occur. As I watch my mother continue her life, though, as I work to 'artificially' alleviate condition after condition that commonly plague the old, I am beginning to consider that what we do as a species to postpone old age and death is, in fact, so much a part of our conscious nature that it must be considered a natural act. What, after all, is more natural than evolution, yet evolution has devised extraordinary changes in what we, as a species, consider less sentient, less self-controlled beings. How unnatural would it have been considered for the first water breather that found itself in a situation where it needed to breathe air to live to make internal changes to its lungs in order to handle oxygen out of water? How unnatural would it have seemed that an earthbound creature would find itself needing to take to the air and devise a way to do this? Nature is a litany of unnatural acts taken to survive beyond threatened lives and environments. It could be speculated that human old age, at this time, is a 'natural' condition whose environment is threatened (which it clearly appears to be; we are, as a species, moving inexorably from the honoring of old age to the trivialization of old age to the eradication of old age). We have not reached critical mass, yet, in the move to eradicate old age but we're headed there. The typical mental and physical manifestations of old age are close to being considered 'unnatural' as treatment to spur their reversal and elimination comes closer to actualization.
    We're not there yet, though. Sometimes, I wish we were. I know that, however edifying I find my mother's ancient mental flights and physical trials, she does not find peace with them. She is, by nature, accepting (sometimes too accepting, but only by habit) but she does not talk herself into believing that any of these conditions are preferred. Because she is still [At this age!] wobbling back and forth between approaching her mortality and denying it I have to surmise that accepting one's 'inevitable' decline and mortality is not anymore 'natural' than resenting and fighting it. The old tell us, in order to celebrate their stamina, that being old is not for sissies. In the next breath, they also tell us that being old is hell and anything that promises to alleviate and/or reverse the process is welcome.
    Dylan Thomas observed that no one should "gentle into that good night" and encouraged old age to "Rage, rage against the dying of the light." It seems, rather than a radical suggestion, his poem is an observance of our innate desire to continue; to turn one's back on the boatman at the River Styx. As a species we seem to be approaching the possibility of this strategy working; of learning how to keep that boatman from grabbing us by the scruff of the neck as we turn away and fight his hauling us into the boat, fare or not.
    I'm beginning to think, as I continue this adventure with my mother, that acceptance of the debilities of old age is no longer 'natural' for us. Perhaps it never has been. At the very least I know that the old themselves are rarely accepting of their condition or their status in society, even as many of them reluctantly give in and "put on a happy face" in an attempt to prolong the sociality of their former 'ages'.
    Evolution, whether or not apparently conscious, is always about expanding options and gaining a stronger, longer foothold on life, whether it be on an individual or community (i.e., species) level. In the case of the cockroach or the mushroom that was discovered a few years ago to be one organism rather than a community of like organisms and, thus, the largest organism we have yet discovered, both individual and community are favored. I am beginning to think that the only thing that is 'natural' about old age is to extend life by attacking the processes of breakdown associated with old age. I know that eventually, because she is old now and not 50 or 100 years in the future, my mother will lose that battle; that, regardless of the technical term used to define what snatches her from physical life, it will be Old Age that finally raises its standard over her battleground. In the meantime I will continue to take every opportunity on her behalf to keep her flag at full flying mast because I know that's what life wants and, being alive, that's what she wants. It's only natural.

In quick time thought...

2003-09-05T10:39:00.000-07:00

...immediately after the last post I did some internal computing and decided to give her a Detrol this morning. It occurred to me that if I give her two Detrol a day and don't keep after her constantly to drink water that her body might retain water rather than sending it directly to her bladder and, from there, directly out of her body. The last time I gave her two Detrol I also noticed that her body indulged in some unnatural water retention, so I decided against continuing that practice; but I also hounded her to drink water that day. Perhaps if I give her two Detrol and let her drink when she wants (she almost always has a cup of decaf coffee going and she does, occasionally, water herself), this will take care of both the dehydration problem, the excessive leakage problem and the unnatural swelling problem. We'll give that a try, today.

Oh, I almost forgot...

2003-09-05T10:16:00.000-07:00

...I'll try to write most of my blood sugar comments here in the journal in larger print so they're easier to read. I wrote so much yesterday on her blood glucose chart that I found it unnecessary to write, here; but I can't imagine that negotiating that tiny print is fun for anyone but me.
Also, as a note to myself, I want to talk a little, later, probably much later today, about the problem of dehydration in the elderly. At the moment it is the only condition we're negotiating that is driving me a little crazy. It is distracting and frustrating to have to tell someone almost constantly, sip to sip, to drink water. I have other concerns about this, as well.

"Number nine, number nine..."

2003-09-05T10:10:00.000-07:00

...can we work any more examples of the number nine in this morning's blood sugar reading? One more; the reading could have been taken on 9/09.
    Interesting developments since dinner last night. Although I got carrot cake to soothe Mom's sweet tooth and administered 1,000 mg metformin to prepare her for the onslaught of simple sugar, she didn't have any. I tried the carrot cake and, as it turned out, it was only spice cake with a finely chopped nut and a sliver of carrot here and there. The frosting, which I typically don't care for, anyway, had an "old cream cheese" smell and flavor. I threw my piece out after a bite. Mom smelled the cake and decided she didn't want any.
    So, it would appear that all the metformin did was bring her blood glucose back in line this morning. However, I also noticed, without specifically looking for it, that she was just a shade paler than she has been. I am beginning to be convinced that there is a connection between Mom taking metformin and being anemic. I gave her an iron tablet for "good" measure this morning and cut out the metformin. I think that metformin, as an occasional drug, might help level her out when she has high glucose readings, low energy days and her glucose level begins climbing until I can convince her PCP that trying other supplemental diabetic medications might be a good idea. But I'm not going to consider it a capital idea as long as I keep noticing that, without fail, when I start feeding her metformin, I also find myself needing to feed her an iron tablet.
    Today will involve much movement for Mom so her blood glucose level should stay pretty tame (I hope, anyway). Besides being a hair day we're going on a Costco supply run and she's already informed me that we will be going up and down every aisle because she hasn't gotten a chance to survey their increasing Christmas displays. She insists we'll be eating lunch there; a polish dog w/sauerkraut and lemonade (a brand of "light" lemonade with sweetener instead of sugar that Costco's soda machine offers and which, much to her surprise and mine, Mom actually likes).
    Our last day fully here in Mesa will be September 12th. Our first day fully in Prescott will be September 13th. Everything is set. Throughout the next week we'll be taking three moving runs up there. As of last night she was looking forward to a busy week beginning with this weekend. So am I. I'll also be "practicing" with the oxygen tanks and Mom as we head up the mountain, a verbal tactic that was suggested by her oxygen technician to convince her to use oxygen on the trip up. She's agreed to allow me these practice sessions. So I think all will run well and smoothly over the next week.

The first words on my mother's lips, this morning, were,

2003-09-03T10:22:00.000-07:00

    "I want to go see a doctor before we go to Prescott to make sure the altitude won't hurt me."
    "Mom, that's what we did on August 14. You were cleared then. You aren't feeling worse, are you?"
    "No, I just want to make sure."
    "Mom, we're sure. Everyone's sure. I know you aren't but we cannot continue to see the doctors you normally don't want to see just so you can look for more excuses not to go to Prescott. Over the last few days you've been anxious to go to Prescott. I know you go back and forth. What's changed this morning, for you?"
    "Nothing."
    "Well, in that case, I can't deal with what has changed since you aren't copping to it so we're going to proceed as we've planned."
    I actually know that she's still having the same emotional problem with Prescott: She simply can't break with the dread she used to feel when she made extended visits to her parents when they lived there. I know all the other details, too, including the business details. I know my details about Prescott, as well, and consider them legitimate. I know it would be simpler if we just sold the place. I know, too, that Mom would start agitating for another place to which she could "get away" and I'm not going to go through that again. Prescott is the territory within which we'll work this through. That's my decision. I don't care to consider anymore how "fair" my decision is to my mother. I'm dealing with someone who is, now, much more vulnerable to whims than she used to be and her whims are no longer well thought out, well felt out or well managed. So we'll do it my way.
    Something I've been meaning to mention: I intend to slowly work away from the incessant finger punchings of obsessive blood glucose testings as soon as I figure out the flow to what happens within her and what we can do about it. My mother is getting tired of being punched (especially now that she feels it). I'm getting tired of following her around with a finger puncher. My intention is for my need for her blood glucose readings to level off once I get a handle on all this.
    On a hunch from a look at her face I decided to give her an iron tablet this morning. I'm not sure whether she 'needs' it, from an anemia standpoint, but I'll be able to tell later from her redness whether it was necessary. Determining what to do medically from observation of a loved one never really reaches an end point. But it does become automatic after awhile, which helps. And, it feels very good to develop this sort of skill.

Just finished some minor editing...

2003-09-03T09:33:00.000-07:00

...fixing links and such, as a few have changed; trying, as yet unsuccessfully, to get rid of the extra row in the A.M. Rx'ed Meds (from 8/14/03) schedule...nothing major, nothing of which a reader would take note.
I'm due to wake up Mom now and running on very low energy today, although the "cold" feeling seems to have alleviated a bit. I may not be back here today...it just depends on how the day goes. It seems as though we've got a lot planned but that could simply be my own resistance to an energetic approach coming through.
Later.

I surged this morning...

2003-09-02T13:36:00.000-07:00

...with barely four hours sleep and plenty to do. After Mom's relatively early rising and breakfast we set out to do The Whole Meal Deal on her hair since her beauty shop was closed yesterday and her regular hair dresser doesn't work Tuesdays. Although it takes me two and a half hours to do what Mom's professional hairdresser does in a half hour or less, Mom enjoys it more with me because she loves having her hair played with and she knows I know it and won't try to involve her in distracting conversation. I actually did a pretty decent job today.
    My plan was that we'd finish reading over the refinancing agreements, get ready and go sign them in front of a notary today. That sounded good until about an hour ago. My energy is plunging and I'm thinking that my metaphorical fevers may have been echoing physical ones. I feel like I have a cold, should have gotten more sleep last night, need ibuprofen and need a nap. Mom seems alert but I think she'll be okay alone. She's got popcorn. She doesn't seem disappointed that we aren't going anywhere today.
    She had a water shed last night. I don't know why. I had her on Detrol. We haven't seen a water shed like this one in weeks. She didn't go to bed abnormally early last night, either, although she was a bear to hydrate yesterday and I sent her to bed on a glass of water.
    Later. Maybe. We've got refinancing papers to read, tonight

Yes, I'm still up.

2003-09-02T02:27:00.001-07:00

    I've been in a fever over the last 12 (or more, I think) hours over a couple of, well, things in my life, none of which has been this web site or its concerns, which has made it a fairly easy target of escape, for me. I did a little work on it on and off, today.
    I did, indeed, reinstate the ill fated Playing With Food website so that I could hook up some more of Mom's history through it, which I did at Mom's History, placed in the central links section.
    I also made a few technical refinements. Although I've been suffering multiple fevers my energy has been, while not low, not high, either. I'm afraid I've been a less than enthusiastic game companion, or any kind of other companion, although I have been jittery. I'm not sure whether that has helped or hurt.
    Back (yes, back) to bed.
    Later.

Two Readings

2003-09-01T15:06:00.000-07:00

    I took two A.M. readings today. The first time she awoke I knew, from her determined voice, that she was not going to remain up. She wasn't ready. I took a reading anyway, just to see if her recent A.M. spiking changes drastically from hour to hour if she arises then goes back to bed, then arises again a few hours later. The difference was only four points. I've gotten four points difference on two readings taken because I wasn't sure I got a good reading the first time. So it appears she's steady as she goes in the morning.
    I gave her a metformin because I determined it is going to be a legitimate slow day. What's the difference? An illegitimate slow day is slow because she's been legitimately slow for a few days (or illegitimately slow and just too stubborn for me). I can tell when she needs to have a fire lit under her because of her grogginess, both physically and mentally. On a legitimately slow day she isn't groggy physically, just slow; she isn't groggy mentally, just somewhere else in time. Usually I can figure out which one it is before in depth conversation begins. Today, though, I wasn't so sure.
    "What do we have to do, today?" she asks, an edge to her voice that tells me she is thinking about going back to bed yet a second time this morning.
    "What do you want to do? It's a holiday. We can do almost anything."
    "As little as possible."
    "Does it feel like a slow day to you?" Usually I don't ask her. The system works better if I figure it out. Today though, because her demeanor is dreamy rather than lethargic, I decided to consult her.
    "I think so," she said, "a day for watching more than doing."
    After breakfast she picked up an 8x10 framed picture of her and her deceased sister and gazed at it.
    "Anything in particular on your mind?" I asked.
    "I was just thinking, this is such of good picture of [MS] and me."
    "Yes, it is."
    "I don't even remember when it was taken. [MS] and I are the last two left of the immediate family. We need a new one."
    This is what I mean by legitimate slow. "Well, Mom, that might be a little difficult, seeing as how [MS] is dead."
    She stared at me, startled, then almost immediately her memories came out from behind the clouds. She smiled, ruefully. "Yes, that would be hard."
    I asked her if, of everyone who had died, [MS] was the person she missed the most.
    "Yes," she said, "we had plans."
    And, they did. They were going to retire together, after their husbands died, to the Eastern Star Home in Phoenix. They had looked at the place, made plans for their rooms which would be adjoining and suited with a door between each. Although Mom felt she no longer wanted to live alone and asked me to come live with her long before any of us knew that [MS] would be dead before 2000, I know she and [MS] continued to talk about this possibility for a long time. They shared visions of what they would do and where they would go when they aged together.
    She's talked to one of her granddaughters and the related daughter today and was so far off she wasn't listening to what they were saying. She stayed on for a few minutes then, in the case of MPS, in the middle of a sentence being spoken to her said, "Well, here's Gail," and passed the phone to me. After I talked to both for a long time Mom asked me about the news but she just wasn't in the mood to hear it directly, today; she's somewhere else.
    I'm pleased that she feels comfortable enough with me to freely go somewhere else when she needs to. If I were in her shoes I'd hate being constantly bombarded out of my reveries within the past if I were in a living situation where days when one is turned away from the here and now are considered suspect or, at the least, to be avoided at all costs. I'm also pleased that she is not in a position where she ends up doing this to the exclusion of everything else, although we've had our moments.

    Just wanted to mention, I talked to our yardman, who is Mom's age, today. He mentioned he is on daily iron tablets "too". Mom isn't on iron right now but I'm sure she will be again. I guess iron deficiency anemia without diagnosable cause is really common in Mom's age group. I know it can be addressed without diagnosis. This makes me feel a bit better about not pursuing anymore internal studies for the time being.
    I'm waiting for someone to make it down the mountain through the inevitably horrible down-the-mountain traffic, so I may check in and out of here, this afternoon and evening.
    Later.

Ramblin' Rose

2003-09-01T07:25:00.001-07:00

    Stream of consciousness, this morning.
    So, I finally did a full check into my brand new stats. Nedstat is recording less than they used to but the data is still useful and interesting. Since I'm using an online web-page editor, every accessing of any page through the editor and making a change and every formal publication is counted as a hit. Thus, on many pages it appears as though I am Narcissus incarnate. I access the index page through the editor at least once a day and it is not uncommon for me to make some tiny change that I have to copy throughout all the pages. Thus, more than once a week I am accessing all pages through the editor. Online editors are notoriously labor and time intensive. The writing goes fast. The editing goessssllllooooowwwww.
    And yet, I even write online, I read and edit my work online, so, I may be the incarnation of Narcissus. One page, though, seems to generating at least some bot excitement, Mom's Test Results. My guess is that its technical jargon is being pulled by a lot of search bots. My surprise is that it is showing up high enough on a list of searches to rate clicking into. It doesn't appear as though it is typical, though, for a visitor to this page to jump to any others in the site.
    Which brings me to a, well, I guess a musing. It is apparent from the search results that I am either getting so few visitors (besides myself and my interminable editing) that it may seem absurd that I talk to my audience as though I have an audience. I am convinced that I do, and a rather wide audience. I just haven't reached them yet, but I feel you. And now I am officially searching, through Nedstat, for you.
    My ISP is goofing up regarding how much space I've used versus my allotment, what they insist on referring to as my "free" webspace (and which I always correct, as, I wouldn't have it if I wasn't subscriber, for good money, to their ISP). I am at only half capacity. Their web-editor stats record me as this, plus, I downloaded all my material, last night and measured it. Just over half capacity. Despite the fact that it is publishing everything I put in it is also complaining that I am way over budget. So after the holiday I'll address this with them. If the site should lock up or become inaccessible for a bit know I'm aware of it and on it.
    I have, by the way, a not insignificant amount of material in a few other sites I took down months ago in disgust. I had not updated them or accessed them for awhile, although they were both still getting visitors. I'm going to ftp those up today, maybe, or at least start and fashion links from these site to Mom and Mom & Me material. It'll help flesh us out.
    In fact, I think I'll begin that process now.

Tonight...

2003-08-31T22:34:00.000-07:00

...I am empty of thought.

Am I recognizing the signs?

2003-08-31T15:09:00.000-07:00

    I think I made a mistake, and I think I might be making another mistake, I'm not sure. A few hours after her breakfast I let Mom go back to bed. I had started doing some cleaning around here, nothing major, and invited her to help me. Although she wasn't into it she moved around some but kept dropping things, sitting down, saying she was tired. I gave in, I let her lie down. I wasn't thinking much of it.
    Now, I'm angry at myself for letting her do this. She is even more dehydrated than she was this morning. I had to stick her 4 times to take her blood glucose level. Her blood sugar is up to 140. I think, what I'm noticing, is the creeping of the metformin lethargy. I'm wondering if giving her metformin, even in circumscribed, circumspect doses is a good idea. I'm going to get her moving around, now. Become The Water Tyrant. I hate doing that and I tell her she is capable of monitoring her own water consumption, but secretly I am thinking she's not.
    Well, up and out. I'm going to try to see to it that I don't feel the temptation to give her metformin tonight. It's just too easy to give her that stuff and then not notice when it slowly sucks the life out of her.

We have some errands to run, today...

2003-08-31T11:35:00.003-07:00

...and, already, it's been busy. I've been in and out of here, but decided to wait to publish until now. A new page for Sep/Oct/Nov has been added: Ain't She 2 Sweet - 2003. The Updates and Test Results pages have been updated appropriately.
    I am so thrilled that Mom is attacking a book that I don't care that the quotes she cares to read aloud to me as she progresses are nothing new, nothing special. I'm going to read the book too, so I can discuss it with her. I'm surprised, sometimes, at the quotes she chooses because I know she's heard them before ad infinitum but they appear new to her in the reading of The Fearless Caregiver. That's okay with me. Her rediscovery freshens them for me. Perhaps the book is a necessary gathering together of the obvious so people will take more careful note.
    We will be up and moving around, today. She's a little dehydrated but we'll take care of that. We. Yes, we. I can't do it without her cooperation, which sometimes becomes very obvious.
    This auto-website-builder is screwing up in its reading of the space I've used versus what I have left so there may be some technical difficulties over the next few days until I can get tech support to do something, but, just to let you know, I'm on top of it.
    Later, no doubt.

My mother has become a Costco aficionado, again.

2003-08-30T12:22:00.000-07:00

    Yesterday she corralled me from sample table to sample table. While we were making the rounds it occurred to me that this was a bullet-proof way of exposing those on specialized diets to the former delights of their now more disciplined palates at least once a week, and it seems to satisfy from visit to visit. Although Mom still wanted a polish sausage with sauerkraut afterwards, depending on the array of samplers I have known her to pass up a proffered lunch.
    At the smoked meat case for bacon I sidled up to a man about my age who was shopping with his father. "Dad," he said, "you love bacon. Get the good stuff. You can afford it." This is not only precisely my policy with my mother, a few years ago I had precisely this conversation with her at precisely this place. This is Costco. Get the good stuff, the lean, thick sliced, maple cured bacon. We use enough so we can buy in bulk. It worked for us. It worked for this man and his dad, too.
    My mother was never the owner of emotional incapacitation in this regard. My father was the needlessly stingy (as well as cleverly frugal and a smart investor) one in our family. His obsessions became her habits. Immediately after his death, though, she recarpeted the house from dirty rust to off-white and purchased a micro-wave before the "funeral baked meats" spoiled and the guests were gone. But when she forgets what day today is, she sometimes thinks we must cinch more than we do and more, sometimes, than is advisable. As well, she is not a particularly materialistic person (both of us delight in our ability to use things beyond what is, today, considered appropriate) so sometimes she doesn't want something simply because the item doesn't matter enough to her to buy for quality. And sometimes, like all of us, her cheaper tastes get the better of her.
    Today is wide open. I might even be spending more time online.
    Later.

I still haven't figured out...

2003-08-29T20:59:00.000-07:00

...how to delete that empty row in the ammended medication schedule for A.M. (8/14/03), but everything else worked, so her med schedule is essentially updated.
Doctors and Patience is taking fine shape in my mind, thanks to the conference, yesterday. I've been spending lots of time with my mother; we've been out a bit, today.
The refinancing papers came today so we're outta here in a little over a week, probably. I'm hoping we'll be able to make a goods delivery trip this weekend, maybe Sunday, and another trip to stop mail forwarding on Wednesday. Then we're up the mountain for the season, maybe a somewhat extended season if the weather is warm.

Just a note to note...

2003-08-29T09:03:00.002-07:00

...I attempted to post the medication addition of metformin to Mom's regimen, but the auto-web-page-program I'm using through my ISP doesn't seem to want to update tables at the moment. At any rate, for an explanation of why and how I'm adding, with extreme circumspection, this medication, see today's blood glucose readings at How Sweet it Is.

No evening blood glucose reading.

2003-08-29T02:32:00.001-07:00

    I laid down for a 'nap' around 1900 and didn't awaken until 2230, after my mother had gone to bed, sans oxygen, sans tests, sans changing paper underwear and completely happy.
    I'm refreshed (unfortunately, I think, since I need to awaken early this morning and usher my mother through a hair-appointment/Costco day), though, and decided to write a Sharing Wisdom Conference Review before going to bed. I gave the review its own page. I still have loads of literature to go through and, for fun, I'll list the goodies I got, but those can come later.
    To publishing and to bed.
    Later.

Blood Sugar Blips

2003-08-28T17:32:00.003-07:00

    Although her Midday is almost ten hours past her A.M., I'm putting it under Midday because I intend to take a reading later tonight.
    She was on her own from 0745 - 1530. When I returned she was up but just up. Same for The Girls (our cats). The popcorn I popped had not been eaten. The soy cracker pouch was zipped. The water had not been drunk. The can of V-8 juice had not been opened. One confirming scan of my mother's internally puckered fingers and I realized it was obvious what had gone on in this house all day. Nothing but sleep.
    It's all right. A day like this here and there give both of us a break. But when my mother got excited over her blood glucose reading this afternoon, I assured her that sleeping all day, drinking nothing and eating nothing is not the way one wants to achieve normal blood sugar. "I allowed that before," I said, "when I didn't know better, and we paid for it. If it is within my power, I'm not going to let it happen again."
    "Well, I suppose not," she slied. My mother. She'll get in as many all-sleep no-anything-else days as she can. I'm a sleep lover, too, so I sympathize but we already know what happens when I let her sleep all the time. Neither of us enjoyed that experience.
    So I gave her a tall glass of diluted, delicious orange juice and placed the popcorn in her eye-sights. Now, I'm coaxing her through 16 oz. of water.
    I dispensed her glipizide without waiting a half hour. I can tell that this evening is going to be All Aboard the Snack Train so it won't matter when I give it to her and it certainly isn't worth it to battle each other while we're both waiting. Sometimes decisions like this are made in regards to medication that are examples of the "art" of medicine, versus the science of medicine.
    Today I was attending the Sharing Wisdom Caregiver's Conference (also known as "Fearless Caregiver Conference"> in Phoenix. I'll review it, later, probably effusively. Suffice it to say here:

I'm glad I went. I'm glad I was offered one of the "few" free placements.
It was kind of a waaaay scaled down Women's Expo for caregivers with a fancy looking lunch and very satisfactory table service, which you can't get at Women's Expo, but overall, Women's Expo is better and more satisfying to its purpose, and it's free. If I hadn't received free entrance I don't know that I would have gone because I am familiar with small scale trade shows (which this conference was), having both attended and put together some and usually, those are free, too, and include comparable food and service.
Although I can say that I met the organizers, talked with them, had some time to sense them and am very impressed, I have to say that the conference needed more organization, maybe more money (perhaps in the way of endorsements and solicitation of vendors) and more sophistication.
The conference gave me the sense of a small but ambitious corporation with a currently small, slick portal and big, slick thoughts, with the added bonus that its founder(s) has a compelling personal interest in Caregiver.com. I don't have a problem with the slick, as it is a fuzzy slick, but I can see that the entire area of business related to caregivers has a long way to go...very promising, and wide open, as well.

    More will be published later, if you're interested.
    Oh. Yes. I've begun to add counters. It is a free Nedstat counter. Clicking on it will take you directly to my stats. Click away. I'm curious, too, which is why I've installed it.
    If I remember, I'll do my "official" review of the Conference in a different color. Maybe that cool, light lavender that I love so much.

A funny thing happened on our way through check-out.

2003-08-27T13:34:00.000-07:00

    I think I've used this intro before but, trust me, you haven't heard this one yet!
    As we tripped smartly through the grocery today, a new one having a grand opening, loaded with coupons for free items, a few of which we needed, my mother quietly placed a super-size of M&M's with Peanuts in the basket. I didn't discover it until I was unloading the cart at check-out.
    "Mom," I pleaded, "I know you really want this, and I feel horrible denying it to you, but, things are going so well, let's not test the waters just yet."
    "You're not going to let me have it." Her voice was triple edged, if such a sound is possible.
    "No, Mom, I'm not. I promise you, you will, again, sometime, be able to eat candy, but we're in a convalescent stage, let's wait a few weeks before we push it." I put the bag into an empty POP magazine holder.
    I continued unloading the basket. Before I was done my mother rediscovered the M&M's with Peanuts in the magazine holder, picked them up and announced, delighted, "Well look what someone left here!" as though Bacchus had taken a personal interest in her.
    I reached across the basket, laughing, and said, "You're a sly one, Mom, leaving it there and then making it look like it was left for you! You must want candy really bad! I'm so sorry, Mom, that it isn't a good idea for you to have it, now. I'm going to give this to the check-out clerk to put back. I promise, in a few weeks, we'll try heavy-duty sweets, again."
    By this time we were face to face with the clerk. I looked toward the tally of our goods and noticed four pairs of eyes glaring at me as though I was, well, taking candy from a baby. As I handed the goody package to the clerk she said, with a good-natured, supplication, "Come on, it won't hurt her..."
    I was surprised but was in an excellent mood and continued, chuckling, defending my case, "Trust me," I addressed all onlookers, "this could hurt. We've been battling anemia and quirky kidneys and her blood sugar for several months and we're just turning it around. Right now, this can and will hurt. Maybe not next time. Where there's healing there's hope."
    It worked. Eyes of humorous suspicion switched to sympathy focus. The check-out clerk one station down from us even said to my mother, "You're daughter's doing you proud. You listen to her, now."
    As we left, I assured our clerk my behavior wouldn't seem so mean next time. Internally I was making a note that this wouldn't necessarily happen because I wouldn't behave this way again with my mother, but, as a result of this incident, these four people would be sympathetic, next time.
    Did I mind? No, not at all, surprisingly. I never mind when people around us ask for explanations of my behavior with and public restrictions on my mother. I really do sense us as part of a community that, if it hasn't yet gotten it about within-family elder care, it's going to get it, through Mom and me, and I love setting an encouraging example. Most of the people who speak out fearlessly on behalf of my mother and the choices into which I steer her (and most of the onlookers) will one day find themselves in one or both of the spaces she and I currently occupy. Even if they share an incident that doesn't appear to be significant to their lives, as I find my mother and myself involved in these events I almost autonomically pump a little extra energy through the moments to highlight the incident for them so it will later be recalled. Insisting that we parade our adventure through the community is exactly how I see us being able to educate the community.
    I remember, a few months ago, when Mom was very lethargic and I could expect a shitting accident at least once a week, in public or not, we found ourselves arriving for one of her hair days a bit late. I had called, but was up to my elbows in shit so I didn't explain until we arrived, sotto voce to her hair dresser. "It's okay," she said before I could finish, "you don't have to explain."
    Without irritation I responded, "Yes, I do. We all need to know how it will be as we take on more and more of this care. We need to know how it will be for us and that it's okay to be this way in public, in polite society. The elders we tend are the senior citizens of our polite society."
    To my astonishment and delight, she understood and agreed with me.
    I never miss a chance to let people see us, interact with us, become actively involved in our appearances and our choices. I like to encourage others, us, to become what we truly appear to have the just-this-side-of latent ability to be: A community that embraces our Ancient Ones and looks forward to being embraced when we are Ancient.

    As a footnote to today's 'funny thing': on the way home, knowing my mother was simmering with sugar disappointment, I suggested an alternative. "Mom, when we get up to Prescott what we should do is, on days when you have sugar-need really bad, we should plan on going out for a dessert dinner. That way we won't have it in the house, we can get really good sugar rather than junk sugar, we'll have a few hours to prepare for it and the money we haven't spent on junk sugar will go toward quality sugar. As long as we can't have sugar that much, anymore, let's turn it into a celebration of sugar's excellence."
    Mom thought this was a great idea. So be it.

April Daily Blood Glucose readings will be published shortly.

2003-08-27T07:49:00.003-07:00

    To give you an example of interesting historical commentary, click into this link.
    March will be next, perhaps today, perhaps over the next few days. I'll also be adding an intra-page navigation section up top and modifying the explanatory material into a more easily read bullet list.
    I think, for September, I'll be starting a companion page, probably called How Sweet It, 2, Is. Seriously, folks.
    Tomorrow will be a hectic day. Expect few to no posts. I'll explain later.

All recent ammendations...

2003-08-27T07:34:00.000-07:00

...will be, momentarily, fully searchable.

Make it a habit...

2003-08-27T05:45:00.002-07:00

...to check out Daily Blood Glucose updates on How Sweet It Is for current news relating to Mom's vitality. I won't bother to repeat that news here unless further commentary seems suitable.

I've posted the Daily Blood Glucose Readings back through 5/03

2003-08-26T15:33:00.000-07:00

They're pretty slim and erratic. I'm including blood test glucose readings as they fit in. I don't think I'll do any more today. It's been a busy day and still I've been able to get in July, June and May. No more today, except, of course, for today's evening reading. I'm not sure what to expect. She's been good, today, and we got out a bit, this morning, moving around, but I feel like I need a short nap and I think she might snack before dinner. Oh well.

Oh, and Saturday...

2003-08-26T00:59:00.001-07:00

...amazing. Again. Or, no, I guess Sunday was the "again". The first "amazing" day was actually Friday. My mother's hair stylist had introduced me to the BBC production of Pride and Prejudice some months ago. I had mentioned to her that I had loved it, it made the story more accessible to me and I was going to look for the VHS set at Costco. In fact, I believe Hugh Grant, who has worked with Emma Thompson in several of her adaptations of Jane Austen's novels, said, during his interview on Inside the Actors Studio he thought Thompson's adaptations were better than the original novels.
The VHS edition hasn't yet returned to Costco. But Friday my treasured mother's stylist brought her entire VHS set and offered it to me. She said she'd picked up the DVD and she knew it would probably be ages before we got a DVD player down here.
I cannot be blamed for feeling so favorably expectant. If I was not afraid to say it out loud, I would announce that I am being blessed. And, I am expecting more.

Something posted before midnight...

2003-08-25T23:54:00.000-07:00

...that's what I want. Then, I'll come back later, add and publish.
    Today was another absurdly lucky, serendipitous day. We received a free microwave. Our old one finally, today, refused to pop popcorn. I decided to visit some friends for the afternoon, leave Mom alone, let her relax and sleep from yesterday's near marathon day. We both needed a vacation from one another [thankyou, that she is alert and healthy enough to be left alone for some hours, now, thankyou on her behalf and on mine]. The friends are MCFs, intimates, with whom I discuss every detail of almost everything and vice versa. I whined that our microwave was dying. They had an extra. She gave it to me. I felt, damn, blessed.
    Our a/c has taken a trip into Insane Land but I'm not considering this infelicitous since it is a 1.5 month old unit. It won't stop cooling so I have to turn it off manually at the circuit breaker. I'm a little obsessive about reading the temperature and sensing it, but that is all.
    Mom was in good spirits. Insisted on playing Sorry. I won three out of four in amazing sets that mimicked each other almost identically. I was delightedly, apologetically astonished, and expressed my inability to do anything about what was happening to my mother. As I mentioned once before, I did not inherit my sore loser/in-your-face winner from my mother, although I didn't from my father, either.
    I'm doing some routine maintenance. Wondering how to express myself today about today in the background. I'll probably be back later. Not sure when.
    I am unusually expectant. Of what, I'm not sure.

Oh. I've added a word...

2003-08-25T23:49:00.000-07:00

...to my journal slogan. Did you notice?

"How Sweet It Is" has become so interesting for me to do...

2003-08-25T23:41:00.001-07:00

...that I will also add links to it on Mom's Test Results page. You'll notice that the sparsest month is 6/03. None are nearly as sparse as June, but 5/03 comes in a close second.
    Initially, I am happy to report that Mom's overall blood sugar levels seem to be doing better off metformin, although I have also been careful to institute firm changes in her life style to which she has mostly been amenable. Either way, every time I can take her off a medication, I celebrate.
    I've also begun to record times of day. You may assume that, if the first reading of the day is a Midday reading, that was probably when she awoke. In some cases, I will remember events happening on those date. I'll also check the Blood Draw histories for Blood Glucose Levels on days in the past, through March, which is where Mom's Glucometer history ends.
    I discovered that peppermint tea in the evening helps relieve her bouts of hiccups. That's nice to know.
    I have it in my mind to write an essay. It is practically complete in my mind, but I've been distracting myself with other interests and curiosities because I think it's going to be a deeply emotional essay, even if it isn't written in a style designed to provoke a tear. I am mentioning it here as a reminder.
    All continues to be better than well.

I have begun Mom's blood sugar history...

2003-08-25T14:55:00.000-07:00

...and have reversed the order of the table in order to make it easier to add stats on both ends. The lastest recordings will appear at the top (or near top). The history will be recorded backwards at the bottom of the chart. That's the way it's recorded on her Glucometer.
It's going to be slow going.

A mildly significant drama is developing...

2003-08-25T10:56:00.002-07:00

...that I intend to solve over my mother's blood glucose. I'm going to begin posting backwards on How Sweet It Is what history I have Glucometrized and see if my contention that her blood sugar is performing "essentially the same" (so to speak) as it did when she was on metformin tests positive. If it doesn't I may consider adding as her PCP suggested, half a 1000 mg tablet, or, maybe, one 850 mg dose in the middle of the day, although I'm not sure if its best to give this medication alone between doses of glipizide or if it works best when taken in conjunction with a dose of glipizide. I'll attempt to run that one by her PCP before I do this. If she begins to revert to her on-metformin demeanor though, I'll immediately stop the metformin. In the meantime, since I expect us to head up to Prescott soon, I may hold off on trying this (unless her blood glucose gets really out of hand a.m./p.m. and is soaring well above 200 midday). Her metabolism may be going through some back and forth adjustments that might settle down when it perceives that movement is going to be routine for Mom.
    The a/c turned out to be a contact problem rather than a thermostat problem so we are good to go for free, since the contact problem is covered under the warranty for the new cooling unit. Excellent.
    Mom's moving slow, as usual, but she's dressed [I gave her a choice of full bath or Baby Wipes wipe-down; do I really need to tell you for which she opted?!?] and arguing about how she needn't run errands with me after her hair appointment, so we're in good order here today.
    And, oh, check out the new Updates/To Do List [As of 11/23/08, hasn't been transferred to new server, yet] item about a new procedure I'll soon be implementing. There is another new item on the What's Next side. Although the list keeps getting longer, I am knocking a few things off here and there as well.
    Later, I'm sure.

Mom was a trooper, today (Sunday).

2003-08-25T01:09:00.000-07:00

    As usual, even though I spent some time yesterday preparing her mentally for an extended shopping trip today, heightening its appeal by promising her that we'd stop for Chinese-to-go on our way home (over the last week every time we pass the franchise in one of our local groceries I've had to steer her away because we already have something thawing for dinner), she was, as usual, hard to get moving. She's never been a morning person and the better she feels (and is), the more likely she is, as she's told many in her family she did as a child, to have a hard time getting to bed because she is afraid she's going to miss something. Now that she's retired she doesn't have a reason to force herself out of her morning lethargy, part of which is due to the late hours she's keeping now. It's a mixed blessing. On the one hand, I am thrilled to watch her slip back into her natural circadian rhythms. On the other hand, one of those natural rhythms is such a slow, gentle morning beat that at least once every morning now I have to turn her back from her bedroom and insist we begin getting ready for whatever we've planned.
    I'm beginning to adjust, sort of, to this. We're eating all our meals later, she's taking her medication later. Unfortunately I'm a very early morning person who would love to be able to go to bed, as I used to, around 2000-2030 so I can arise around 0300 or 0400. I want to be up with my mother though, and it's easier for me to adjust than her so I'm spending a lot of time burning my candle at both ends these days. My energy level remains very high and seems to be able to refresh itself with a dead-to-the-world afternoon nap every four to five days while Mom is napping.
    Today at Walmart in the fabric department, the associate who waited on us was a woman in her mid 60's. After she measured and cut the facing I was purchasing she turned and caressed Mom's back, smiled with delight and said, "This is your mother, isn't she? You're very lucky."
    "I know," I said, smiling back with equal delight. "I'm her companion."
    "I could tell," she said. "You remind me of my sister and my Mom when they're out. She's, oh, 86, now."
    "So's my mom," I said, reaching over to join the woman in rubbing my mother's back. Because of the occasional disapproving looks I get from those distant from their own Ancient Ones when they see my Ancient One pushing the cart while I'm meandering alongside it is automatic for me to mention that she walks better when she's pushing a cart, thus, she walks more.
    The woman waved away my explanation and my concern. "I know," she said. "My sister does the same thing. It's good for them."
    While both she and I rubbed my mother's back and arms and my mother grinned (and probably purred) like the Cheshire Cat, the associate and I chatted a bit about our parents' "times past", as she put it. She asked my mother a few questions, having to lean into her and repeat them, then nudged me and said, "My mother doesn't hear very well either," as though it was a joke Ancient Ones play on the rest of us. "Pay attention to her," she advised me. "She knows more about life that any of us. She's seen so much."
    She went on to thank me for being my mother's companion. "I'm so grateful my sister is doing this for my parents," she added. "I tried to keep up with [her parents] for awhile but it was impossible. I'm lucky to have my sister be able to live with them, take care of them, make sure they live well [I'd never heard it put this way, before]. It takes a load off my mind. When I was doing what I could, we'd hire people to be with them when we couldn't be there but we all worried so much. Now that my sister is with them we're all so relieved. It is a wonderful thing you're doing. People you don't know appreciate you for it."
    By this time my mother was beginning to show signs of wanting to move toward the exit. I began making our apologies, thank-yous and good-byes. The associate said, "I can see she's ready to sit for awhile. I'm glad you came in. I hope someone is telling my sister, today, what a good thing she's doing. Don't forget how lucky you are."
    I won't.

    This evening we played three long, animated, teasing games of Sorry, which we bought today. It's a hit with both of us. I won all three but this time it was strictly chance. I've noticed that I've been experiencing a run of extremely lucky, felicitous days recently. I even took the trouble to explain this to Mom. I was beginning to feel guilty for winning so much. Last night in one Yahtzee game I got four Yahtzees. I needn't have bothered. She is neither a sore loser nor an in-your-face winner like I am so she wasn't bothered by it. After some initial groping to remember the rules and argue with the box about how "they've changed since the last time I played" she settled into the game and played zestfully.
    In the last week as well, I discovered that our cable channel has several music stations. Mom woke up from her nap, I think it was on Tuesday, as I was playing the Big Band station to help settle and revive me from a series of frustrating, anger producing phone calls over a business blunder to which I couldn't seem to get the perpetrator (a bank) to admit, much less apologize for and solve.
    "Where's that coming from?" Mom asked as she entered the living room.
    Over the last few years she's been so super-sensitive to music that she hasn't wanted to listen to it and I've taken this debility on, although I've also been forcing myself, for the last half year or so, out of desperation, to work myself out of it. I scrambled toward the TV in response to her question. "Here, Mom, I'll turn it off. I just needed to listen to a little music."
    "No. Leave it on." She was waving her hand to the music as though she was scanning a hall signaling her availability to potential dance partners. "It's been a long time since we've had music around here. It's nice." She two-stepped into the dining room to look for her coffee cup.
    Since Thursday the Big Band station has been playing regularly at our house. Tonight while I was rubbing her down she asked if that was the only station. I ran through the line-up and she chose a few she'd like to try "later". "Do you mind?" she asked.
    Absolutely not. I didn't think the reintroduction of music into my life, let alone hers and mine, would ever happen again. It is my pleasure.

i...

2003-08-25T01:07:00.000-07:00

...ambeingblessed.tomycore.

Reading online journals backwards...

2003-08-25T01:00:00.000-07:00

...is disorientingly weird.

Something else I want to mention:

2003-08-24T00:30:00.000-07:00

    When we both found neither of us could face another game I asked her what she wanted to do.
    "Just hang out," she said as she headed for her rocking chair and TV table to read her new gossip tabloids. It's been a long time since she's voluntarily chosen to entertain herself. One more victory. This woman may surprise everyone. She may well live to be 120, as she often says she intends.

    Tonight when I was rubbing her feet, after telling me, as she usually does, how good it feels (especially the part where I work her soles and feet over) she told me something interesting.
    "You know, I tried to do that for Mother [her mother], rub her feet, and she didn't like it."
    "Really! I can't imagine anyone not liking it! When was this?" I asked. "When you used to stay with her up in Prescott after Grandpa died?"
    "No. This was after she moved down to Scottsdale when she was in the mobile home."
    "Did it bother her? Did it hurt her?"
    "No, I don't think so, she just couldn't handle it for very long."
    We contemplated this while I continued rubbing her feet and legs.
    "You know, Mom," I speculated, "I don't think it was because you were doing anything wrong or physically irritating her or anything. Now that I'm thinking about it I think Grandma was the kind of person who couldn't really enjoy someone doing something like this for her."
    Mom thought about this for a minute or two. "What do you mean?"
    "Well, Grandma was so very independent. That was a fundamental part of her character. In order to enjoy the possibility of a good foot rub you have to allow yourself to be vulnerable to what someone else does to your feet. I think maybe she just didn't want to become that dependent on anyone to provide her with anything. If she got to the place where she liked foot rubs she'd be dependent on other people to provide them for her. A foot rub doesn't ever feel as good when you do it to yourself. It think Grandma's baseline motto was, 'If you can't do it for yourself it's better to do without."
    Mom smiled while she took a minute to think about this. "Mother was certainly independent."
    "Fiercely. She was so independent she didn't even depend on her husband. He depended on her. I don't think that was a circumstantial necessity for her, I think she was always that way and just happened to find the right man who would not only put up with this but enjoy it."
    Mom laughed. "You're right about that!"
    "So I think the whole idea of foot rubs, massages, anything like that, probably made her really impatient. If she couldn't do it for herself it wasn't worth having someone else do it for her."
    "You know, I never thought about it but I think you may be right."
    Sly, as usual, but this is her way of saying, "I agree."

    We talked some tonight, too, about how I managed to grab ahold of her this fall, pull her out of the clutches of doctors, her resignation, her body going haywire and my fears and walk her back to being interested in life again and healthy enough to enjoy her interest.
    As the conversation closed she said something I never expected her to say, mostly because I never expected her to really be aware of how far she and I have come in the last year. She leaned forward in her chair, looked me directly in the eye and said, "I'm really glad you did. I don't know if I've ever thanked you for that but I want to now. Thank you."
    You're most welcome, Mom. Thank you for allowing me to guide you back.

"It's time we considered adding another board game to our repertoire,"

2003-08-23T22:52:00.000-07:00

I suggested tonight, when we both tired of Yahtzee and Scrabble.
     "What makes you say that?"
    "Oh, I don't know, it just seems like we could use some variety."
    "I think you're right. Let's take a look at what they have when we go shopping, tomorrow."
    Whoa! I couldn't believe it! She remembered we're going shopping tomorrow. This tells me she's looking forward to it.
    Earlier today after she had lunch we needed to pick up a few things for dinner. Although she wasn't happy about it, I insisted that she go with me. First she had stuck her head in the refrigerator immediately after eating. "Are you hungry or bored?" I asked.
    "Bored," she said, and closed the refrigerator door.
    "Okay," I said, "come to the store with me, push the cart around and do some people watching."
    She agreed while I was in the middle of folding clothes. I told her I'd be ready "in about fifteen minutes."
    Within five minutes she was taking off her glasses and heading toward the couch for a nap.
    "I'll be done here in ten minutes. Are you tired or bored?" I asked.
    "A little of both," she replied.
    "Okay, if you want to lie down I'm going to get you up in ten minutes to go to the store with me."
    She looked at me as if to accuse, "Slavedriver," but she sat in her rocking chair instead of laying on the couch while waiting for me to finish folding the laundry.
    When we returned from the store she didn't make any attempt to take a nap. Several hours later as I was preparing dinner I mentioned to her that I was noticing that if she gets moving a little right after a meal she is less likely to take a nap.
    She was surprised at the observation but agreed. "Moving around takes care of that," she agreed.
    "What we should do, then," I ventured, "is plan some kind of activity that requires movement immediately after breakfast and lunch and maybe even dinner," I suggested.
    She didn't immediately respond. It occurred to me that she hadn't heard me but I gave her a few more minutes.
    "We could give that a try," she said tentatively.
    I laughed. "Don't worry, Mom," I said, "I still don't have marathon training on the schedule."
    She laughed. "Let's not plan that for a couple more months."
    I'm noticing that in daylight she is quite ruddy now. I think it might be time to cut out the one iron tablet she's taking and see how she does without it. I might add it back to her diet when we first get up to Prescott just to boost her blood a little since she'll be adjusting the the thinner air and will most definitely need to be on oxygen, at least at night, and may even chose to use it intermittently at first when we're out and about during the day. The more I can get her to move though, the faster I think she'll adjust. She's still not looking forward to getting back to Prescott but she's not giving me that "here's mud in your eye" look anymore, either, when I mention it. That's a good sign.
    She's ready for bed. Time to rub her feet and legs.

Mom and I have been playing board games, lately...

2003-08-23T19:48:00.000-07:00

...and it's been an interesting enterprise. Today is our third day (not in a row) of playing. Although Yahtzee is primarily a game of chance her problem with it has been remembering enough about scoring combinations to make smart decisions on what to keep and what to roll again and remembering to check on what she has versus what she needs. Today it went much more smoothly than our previous two sessions. She always starts out as though she has never played but each time we've played she's been in need of less and less coaching. Today, during our second round, I started to coach her on how to use a roll and she playfully snapped at me, "Don't help me, how do I know you're not trying to make me lose?!?"
    Scrabble has been the real surprise, though. With each of the three games we've played her score has improved by more than a few tens of points. She hasn't beat me yet, which she used to do regularly, but she's getting close. For all three games I've allowed her to use the dictionary before putting down a word. I figured this would help her remember her love of singular words. Today, about three quarters of the way through our game, she asked, "Aren't you supposed to use the dictionary after a play, when you're challenging someone?"
    "Yes," I admitted. "I just thought you could use the help, while you were getting back in the saddle."
    "Next time, let's do it the right way. That means you can't use the dictionary to find words, either."
    Whenever I give her a break I take the same break, and she's beginning to get wise to this.
    I swear, I pay the same amount of attention to her game scores as I do to her blood sugar numbers. As her scores rise I celebrate, both internally and externally, her reviving awareness.
    She just interrupted me here at the computer. "Do you want to go on with what you're doing there or let me beat you at Yahtzee?" she asked.
    I laughed. "I'd rather let you think you're going to beat me at Yahtzee."
    She laughed.
    So, we're headed back to the boards. More later.

I've begun a table of Mom's daily blood sugar readings.

2003-08-23T09:00:00.002-07:00

You can find it on the page entitled How Sweet It Is. Details pertaining to taking and posting these readings are on that page.

Caregivers Taking Care of Themselves

2003-08-23T08:53:00.001-07:00

I've finally managed to get back to this subject. My entire definitive rant can be accessed at my fledgling essay section under the title "Take Care...". The title is a direct link.

My mother's sense of her personal control over her life...

2003-08-21T06:12:00.000-07:00

...was on my mind when I awoke this morning. I walked on it, still haven't come to any conclusions, so I'm writing about it.
    When one is a caregiver one's sensitivity to another's sense of personal control over her/his life is one of the trickier areas to negotiate. I realized last night, after writing my last post, that over the last two years I have not been handling this area of my mother's life as well as it could be handled, all the time thinking that I was doing well.
    It was two to three years ago when my mother began saying, "No" regularly to lifestyle changes in order to enhance her health, taking emotional responsibility for decisions she had made such as buying the house in Prescott, accompanying me on errands, visiting relatives and friends, attending business meetings, phone calls and negotiations, paying her bills, bathing on a regular basis, even getting out of bed in the morning. Being her companion and taking into account her age, as each of these hurdles appeared I took responsibility for clearing those that required action and allowed her the choice of no action when the hurdle was something that required only her action, such as appearing physically in the world beyond our homes. My reasoning has been that there are areas enough in her life where her control necessarily needs to be augmented by my involvement (in many cases, heavy involvement, such as her decision, in 1997, to buy a 'summer home' in Prescott) in order to protect her and make sure her decisions unfold felicitously as much as possible. Thus, I felt that she had a right, and I had a duty, to allow her to make what decisions and take what action (or non-action) that still lay within her grasp.
    As I look back I realize that allowing her to say 'no', in many cases, undermined her physical, mental and emotional health to the point that we have spent the last year negotiating crises in all these areas. As I let her refuse changes to a healthier, less sugar laden diet, as I allowed her to give in to her lethargy, as I chalked her decreasing involvement in the wider world up to her natural, life long tendency to keep her circle of family close around her in lieu of neighbors and friends, as I accepted her decisions not to accompany me on personal business appointments involving her affairs, I think I also undermined her ability to be present in her life.
    Both of us, especially me, have been very lucky. Within the past few months it appears as though much of what I allowed to occur in the name of preserving her personal sense of control over her life is reversible. Aside from learning an astonishing and valuable lesson about the resilience of Ancient Ones, I am grateful that I got a wake-up call late last summer that I could not ignore in the form of her health crisis.
    Now I am finding that I am having to internally scramble to redefine how to make sure that, as her sense of her life revitalizes along with her body, I do not, once again, take steps that insidiously undermine her sense of personal control over her life. I'm still not sure how to do this. For the last two and a half years gentle reasoning has not worked with her so I've begun to narrow her choices. I no longer ask her if she wants a salad at dinner, I prepare one for her and inform her that she must eat it (and she does). When we are in the store and her sugar detector locks onto a sweet treat I no longer explain the consequences of her choosing to buy and eat this treat, I say, firmly, as I did yesterday, twice, at Costco, "No. We're not playing the sugar game, anymore. We played that for two years and we almost lost." When she begins to try to turn her day into one long snack, even though the snacks we now stock are all healthful, I no longer struggle to try to figure out how to administer her diabetic medication under adverse circumstances and still have it do some good. I monitor her snacking to accommodate the requirements of her medication. When she decides to spend the entire day in bed I no longer allow this, even if I have to use physical influence (such as gently moving her body into a sitting position on the edge of the bed or catching her as she's heading for the bedroom and turning her around). When she complains that she is bored and thus has a right to give in to that boredom in bed, I tell her that she can be bored just as easily in her rocking chair as she can in bed and it's healthier for her to sit up. When she awakens in the morning not wanting to move around I remind her, firmly, that every time I've forced her to get up, bathe, eat, get dressed and accompany me on errands she has felt better and been grateful to me for having done so.
    Yet I still feel as though I haven't discovered the secret to allowing my mother the dignity of feeling personal control, even as her ability to control her life diminishes. I have an advantage, of course; I am her daughter, we know each other intimately, truly enjoy each other's company and characteristics, thus I have a well stocked collection of personal resources I can peruse to find the best, most potentially cooperative (rather than dictatorial) avenue toward this goal. I am nowhere near mastery of this task, though, and sometimes I wonder what mistakes I am making of which I am unaware and that have the potential to usher in another crisis. I'm trusted more than someone outside her immediate family. This, though, doesn't always work for us, as I am also the one in her immediate family, being her live-in companion, whose opinion and suggestions she is least likely to consider, being so familiar with them.
    We, her daughters, spring from relentlessly independent stock. It is more than preference that each of us clings to our insistence on keeping our own counsel, making our own decisions and resolutely living with the consequences without apology or regret. It is a matter of early training and, I think, genetic design. And now I am having to confront the source of these life strategies head on in my mother and negotiate around them in order to enhance the quality of her life and, in some cases, continue her life from day to day. On the one hand, the task is daunting. On the other, I believe that it is precisely my mother's strong sense of independence, individuality and self-possession that keeps her from, for instance, giving in to what could have been a fatal blood pressure crash almost a year ago.
    If you think caregiving is a matter of following a set of rules set by professionals without factoring in the uniqueness of the person for whom you are caring, you need to think again.
    The dilemma continues, amazingly, so does the exhilaration and, appreciatively, her life and mine continue...

Yesterday morning...oh dear...

2003-08-20T21:04:00.001-07:00

...yesterday morning was not one of my shining mornings, but then neither was it one of my mother's. I'd been running on an extraordinary energy surge that had lasted for several days and allowed me to accomplish amazing feats with little sleep. I'd gotten so used to the surge that I had been planning my days around only a few hours of sleep a night. Tuesday morning was my Waterloo. Although I didn't have to haul myself out of bed, my body hadn't achieved that level of stubbornness, I felt as though I was down three quarters of a tank. My primary physical behavior yesterday morning was yawning, over and over and over.
    I managed a few good ones before I stumbled out to our main living area. Although it was somewhere between 0930 and 1000, Mom was up, sitting at the table looking as bright as her new yellow bathrobe. She'd been up for about 15 minutes, she said.
    I was pleasantly surprised but my fatigue betrayed me and I continued yawning. Each time I started a good yawn my mother said (one of her teases she's been doing for years), "Close your mouth."
   I've always found this mildly irritating but have tolerated it without thought just to humor her, closing my mouth over the yawn, which frustrates a yawn just as efficiently as having someone say, "Close your mouth," and produces a facial distortion that she finds humorous.
    Yesterday morning I was not in the mood. I needed several good, deep yawns just to get going and she was interrupting each one. Without warning, 52 years (well, a few months shy of 52 years) of frustration poured out of me. I lit into her. I told her I was severely sleep deprived and I needed to yawn. I told her that the more she did this, the angrier I was becoming. I asked her to stop in no uncertain terms. Then, falling into my usual anger mode, I quickly whipped up the icing and began spreading it on the cake. The following is paraphrased from memory.
    "You know, Mom," I began, "you've always done this, ever since I can remember, and it's always been both irritating and frustrating. Yawning is not only triggered autonomically, it's necessary and it's pleasurable. You need to stop interrupting people's pleasure. This isn't the only thing you do to keep people you love from feeling pleasure. Your habit, for instance, of offering a back rub and then, when you're done, slapping the person right where you've been rubbing them is just as frustrating. You know, I give you very pleasurable foot and leg and foot rubs every morning and every night. I do all kinds of things that give you physical pleasure and I purposely go out of my way not to disrupt the stimulation and relaxation these give you. You need to stop doing this to me and, for that matter, to others. You are a sensitive woman with much personal dignity and awareness. These ploys are beneath you. It's time they stopped."
    Whew! Did you get that?!? It's rather like the time I severely corrected my mother for interrupting people when they're talking and announcing, "Oh, she/he doesn't know what she/he is saying." It's in the history. Now that I'm reading my paraphrase above of what I said to her this time, it feels so fresh that I'm sure it probably is much closer to what I said than I imagine.
    The funny thing is, when I raked her over the coals for belittling what people say she never did it again. Although we haven't had occasion to test yesterday's correction, I suspect it will work as well.
    I don't know if I was unnecessarily severe. I do know that within minutes I felt horrible and began apologizing for my method, although, I continued to point out, the subject was important. I also launched into a litany of apologies for some behaviors that have been habits of mine and not only irritate my mother but sometimes confuse her and certainly make her feel as though she has no control over her life, one of the things I've been trying to change (search out archived post from some days ago regarding the possible psycho-causes for my mother's anemia). The worst example is my habit of giving her a choice of just about anything; food, activity, timing, etc., and then canceling her choice and telling her the opposite is more practical, wiser, etc. I told her I won't do that again, and I won't.
    The matter, however, was her interruption of other people's pleasure. After the episode was over I gave some serious recollective thought to it and realized that it is my understanding that my mother has habitually and 'teasingly' interrupted other people's small physical pleasures because she may have continually had her own physical pleasures either belittled, interrupted or ignored all her life, by everyone in her life. A previous subterranean consideration of this is precisely why I instituted my personal policy of giving my mother physical pleasure and allowing her to enjoy it without interruption (although I'd never consciously thought about it). It gives me a great deal of pleasure, sometimes physical pleasure, to do this for her, in part because I know no one else has.
    The curiosity in all this is that almost every time I rub my mother's feet and legs she offers to rub mine in return. I have a standard oral essay to which I subscribe and which I repeat every time she offers. I tell her that massage is so pleasurable that it should never be 'traded' in return for a massage. It should be given freely with no thought of return by either the recipient or the masseuse. When someone gives a massage 'in trade' they usually don't pay attention to the body they are massaging, to the reactions of the recipient, they don't massage thoughtfully with involvement, they simply complete a barter.
    Not that people should never ask for physical pleasure but the pleasure for which one asks should be granted only if the one asked wants to give pleasure without trading it. I know, I'm going against all the 'good advice' of a couple of generations of sex therapists. As well, people should become more habituated to giving physical pleasure without waiting to be asked. Otherwise, the person giving the pleasure is not focused on the recipient but the result, their payment for the pleasure given, and don't devote themselves wholly to the task of sensitive pleasure giving. Thus, the person receiving the pleasure is never allowed to really relax into the experience and receive its full benefits. Again, I know I am facing down centuries of 'satisfied' johns and janes. But none of this disproves that as a society (I'm speaking of this one in which my mother and I live) we may very well be in the habit of not knowing what heights of pleasure and relaxation we can achieve because we're trading pleasure favors instead of freely giving and receiving pleasure.
    If you doubt what I'm saying, those of you who enjoy being licked by your pets (who invariably stop if you begin to pet them while they're licking you), think about how enjoyable is the reception of free pleasure, how much longer the afterglow lasts when you know you are not being expected to return it and how, often, your instinct in that relaxation is to reach out and scratch and stroke your pet, your fingers seeking out exactly those places where you know your pet most enjoys being caressed.
    The above anecdote is an excellent example of how my mother and I learn and grow with each other. Sometimes it get tense and maybe a little out of hand. But, one way or another, we manage to understand each other, make amends and increase our level of mutual enhancement, which is possible even when a day begins in a very bad manner.

Regarding Mom's test results postings:

2003-08-19T15:05:00.001-07:00

    I decided not to seek out any test results from the PCP she visited before we switched her to her current clinic because I realized that any test results would tell more about her former PCP and his doctoring habits that they would about her.
    I have a good recollection of her relationship with her previous PCP and an excellent recollection of my relationship with him that began when I realized it was becoming necessary for me to become involved in this aspect of her life and be present to record and remember what he told her and what medications and actions he prescribed. I don't think he was a "bad" doctor but he was clearly overbooked, overworked, and intimidated by the relatives of patients who acted on the necessity of becoming involved in their loved ones' medical care. I also remember that he took and required few tests. Some of this may have been because up to the late 1990's her health was in excellent order. Beyond that point though, especially when he began prescribing metformin for her, he did not monitor her adequately, did not inform her that self-monitoring was necessary, gave her some printed information about diabetes but dismissed it as he was giving it to her and the only statement my mother remembered of his management of this particular dis-ease, from the day he put her on the metformin, was that he said, "...you can eat all the popcorn and peanut butter you want." Because he did not monitor her from the beginning she stopped taking the medication soon after she'd started. It made her "feel bad"; which is to say lethargic and foggy, and despite the fact that I'm sure her blood sugar was on its way to thoroughly saturating her blood at that time, she felt much better off the medication for awhile.
    I will be continuing my collection of test results from now on and poring over them as has become my habit, learning as much as I can about how to interpret them for clues about handling her day-to-day health.
    Oh! I almost forgot. The very last test I input this morning for which blood was drawn on 7/27/00, much to my surprise, seems to indicate in the context of all her other tests that she was beginning to develop waves of suspiciously anemic conditions back then but which were not addressed at that time. As I look over the tests I can see why. Sometimes her blood was in perfect order, sometimes it wasn't, but there was no consistency to these indices except for their inconsistency. I'm pleased that they became consistent enough within the last year for this to finally be addressed although I also, now, see why it is so hard to determine the cause for her anemia and why, although it appears to be somewhat likely that she intermittently bleeds internally, this also may not be the case. It's important, I think, for me to keep in mind that she was at her most severely anemic during the period when the colonoscopy was performed on her and yet, without discovering any indication of internal bleeding, her anemia cleared up more quickly than is usually the case after the procedure. Despite my insistent questioning of all that her doctors have been doing for her, I am now grateful that they have been paying close attention to her for the last year, am more sympathetic with their dilemma in regards to her anemia and am going to write her PCP a letter today expressing both my further understanding of this issue and my thanks for his care and his endurance of my involvement in her care. I am thinking, too, that both he and I (and, perhaps, the entire institution of medicine) had and have a lot to learn about managing intermittent, resistant anemia in the elderly and I want to express to him that the more information he can give me and the more he can help me consider all the personal-to-my-mother and general information about this problem, the more likely I am to go along with his recommendations, even though I may initially question them.
    It is fascinating to me to consider her health in light of the series of tests from this PCP but it is also interesting to consider the dynamic state of medical laboratory technology, which is clearly indicated as I peruse the history. Not only do reference ranges change depending on the vendor of the test and demographics regarding test results as they are recorded and processed throughout the nation (and, I'm wondering, possibly the world), but groups of testings one can order and the ability to get usable results regardless of the state of the testee's health and ability to maximize themselves for usable results continues to upgrade. I read yesterday, in a book I have just begun (published in 1999), that computers are beginning to edge out doctors in the ability to sensitively diagnose individuals. I'm not surprised. I know this is going to usher in (already has, in fact) a difficult period in medical treatment for both doctors and patients, in large part because past expectations and what was once legitimate ego gratification for both doctors and patients due to the "doctor as God" syndrome will have to change. But I find the possibilities exciting and am pleased that my mother continues to live to take advantage of these pregnant possibilities.
    I should mention that there were two urinalyses which I did not post. Both were done to diagnose and treat a severe bladder infection (which turned out to be caused by Strains 1 & 2 of Escherichia coli) that precipitated a change in PCPs. The tests merely confirmed the diagnoses and that she was on appropriate treatment.
    Lastly on this subject, as I recorded tests I also became aware of mistakes I made when posting previous tests, mostly in names; i.e., I was, for awhile, recording "Alkaline Phosphatase" as "Alkaline Phosphate". I noticed as well that I have been occasionally misspelling "Albumin", which I have yet to correct. As I come across these I will correct them. If any of my readers discover or question the veracity or correctness of any particular postings, please feel free to let me know. As well, it is interesting to me to note how the labs become clearer in recording the names of tests as time goes on and the changes in names, etc., of groupings of tests. I've been noticing, too, that tests for certain values of particular chemicals or conditions in the blood become redundant as time goes on or, I suppose, unnecessary and not cost effective, so these are dropped and, as they are dropped, the names for particular groupings change. Very interesting field! Gives me lots to think about!

All Mom's medical test results history...

2003-08-19T03:34:00.000-07:00

...ordered through her PCP have been posted. I'll have some commentary soon, perhaps as soon as tomorrow, regarding whether I will attempt to attain other test results and reports taken in this time period by the gastro-enterologist who performed her colonoscopy and the test results that exist from her overnight hospital stay in the fall. For the time being though, I'm not going to worry about those, as I am quite clear on what happened and why in regards to those two events without the tests.
    I've made some interesting discoveries about tests and about my mother's medical history. I'll cover those later, as well.
    At the moment I'm going to publish, update the search index, cover myself on my futon and get some sleep before Mom awakens this morning.
    Just a note, we had an excellent day today. Mom was in a very good mood, joined in a raucous, heated discussion about men, sex and gasoline (yes, all in the same savory stew of words) at the salon with three others including me, exercised behind yet another shopping cart, decided we should adopt a baby kangaroo and a dog who will nurse kittens, and slept very little outside of her usual night sleep and her two short naps. I'm sitting here smiling as I write this. I had a good day, too.
    Good, good night.

Why do I include all the personal detail here?

2003-08-17T02:25:00.000-07:00

    I'll get to that in a minute, after I add more detail, both technical and personal.
    Today's been a busy day so I haven't added any more tests. I did manage to revise Mom's medication schedules and began cleaning up the existing test results so that when I copy those in order to plug in new dates, times and numbers I don't have to repeat all that information. The cleaning up includes adding glucose numbers, collection times (to show her various states of glucose spiking, especially in the afternoon) and noting whether or not she was fasting, since I know where to find that information on the tests now, and moving all Hemoglobin A1c results to separate tables. I still have a ways to go. Tomorrow promises to be a somewhat lighter day than today, although I never know. I didn't realize today was going to be heavy duty but I'm pleased with how it turned out.
    I was adamant about getting Mom up and moving today, although she didn't actually eat breakfast until around 1100. Once I got her going though, we went shopping for a new Scrabble game and took an extended trip to the grocery. She resisted and I became a bit pushy but, as usual, Mom was later pleased that I'd insisted. She didn't even take a nap this afternoon. Too much was going on and she was too alert.
    An interesting incident happened at the grocery. About half way through our list I noted, by smell, that Mom was having a fecal accident. I mentioned it to her discreetly. She was sure she wasn't (sometimes she has no idea this is happening). Once we got to the bathroom though, we discovered she had and it had just begun. Naturally, today of all days, I'd neglected to bring the bag I typically carry with baby wipes, a few extra pairs of paper underwear and an extra set of clothes. Since we caught it so quickly the clothes weren't necessary and I made do with the cleaning supplies in the bathroom. I needed pads though, so I left her in the bathroom in the handicapped stall (which works better for these incidents since I need to be in her stall, too) and retrieved a package of paper underwear from the store shelf, later paying for the ripped open package.
    There were two curiosities surrounding this incident: The total movement was massive and she was completely unaware not only that she'd begun before we got to the bathroom, but that she had continued while sitting on the toilet as I cleaned her. I've given some thought to both of these aspects of today's accident. Although I've noticed over the last few days that she had been going to the bathroom at home, spending a lot of time in there and coming out without having an apparent bowel movement, I'd asked her several times if she is constipated and she's been telling me she is not. Today's incident told me she has indeed been constipated. We talked about this later. I told her that when I ask her this I have a reason and I need to know if she is "having trouble" eliminating in order to short circuit events like today's, which I usually can do. I also spent some time explaining to her why this one happened. Although she has been moving more than usual, I explained, her body is signaling that she isn't moving enough anymore to accommodate her revived condition and we need to consider, now, adding a little more movement. We discussed a variety of strategies which will be implemented slowly, such as taking a short walk in the morning immediately upon arising, setting a regular rising time in the morning regardless of whether we have "plans" and limiting the time she naps. Although she was not keen on any of the suggestions she agreed that we needed to do something and we "may as well try" what I suggested. I relayed all this information as encouragingly as possible, telling her that all of this was a good sign; that her body is, essentially, saying, "Ma-ry, oh, Ma-ry, I'm ready to be more active again."
    I'm still not sure why she was completely unaware that she was having a bowel movement throughout the entire incident. This is only an occasional occurrence, now. It's been almost a month since she's had an elimination accident, mainly, I think, because her body awareness is returning. We discussed this, too, and I told her that today was part of her Early Warning System. Although she did move and get out some yesterday, she also spent a lot of time in bed, went to bed early and woke up late. "Mom," I said, "we have the choice of falling back into the mode you've been in for the last two years but I've just about decided to refuse that choice. Now that I know it is reversible I'm focused on making sure it doesn't happen again."
    She was reasonable in her response. Most of the "lecturing" I did today was a pep talk. I surmised, out loud, how I feel that, although her anemia was not caused by actions we didn't take, it worsened because I gave into her increasing and seemingly insurmountable lethargy and now that I understand this, I'm not going to let it happen again. I talked about how, since the accidental colonic preceding the colonoscopy, she has been so much more alert and revived that I can no longer accept that the last two years of her entrenched lethargy are simply due to "old age". I offered her a heart felt apology for having allowed this to happen over the last few years, promised her that I was learning my lesson and pointed out to her than in less than a month all her dangerous health conditions (anemia, CHF, diabetes) have begun to reverse themselves even as I have been cutting back on her medications. Thus, neither she nor I can any longer assume that what has been going on the last few years is normal. She 'agreed' in that sly way she has of getting someone to shut up, with which those of you who know her are familiar, and at that point I dropped the subject.
    Interestingly, although she had been a bit slow both physically and mentally this morning, immediately after her massive elimination her energy shot up, her alertness improved, and as we finished our shopping she was stepping smartly about the store, passing me as I browsed for the items on our list, anxious to hit the next aisle to see what was there. I mentioned this to her, too, and she enthusiastically agreed that she was feeling much improved.
    So we played a round of Scrabble this afternoon. I forgot to mention that when we played Yahtzee last night, I had to reteach it to her, although she absorbed it fairly well. The same thing happened with Scrabble. A couple of times when she was fixing her letter holder with what appeared to be a confused stare I gave her clues about what she could do with her letters and the ones already on the board. A few times, as well, she didn't recognize obscure words that she normally would have jumped on by dint of also being an avid crossword puzzle fan, but this appeared to be reversing itself by the end of the game. As we both found places for our very last letters she was recalling quite a bit, including her strategies for racking up points. I think the key, now, is to keep up games like this, encourage her to get back to her crosswords and get her out more.
    I am very encouraged by today. I felt as though we were siphoning into the more obscure healing powers of god/God/All and it was all working. I promised her, as I do whenever she begins to look boggled by what she imagines will be the expending of unpleasant effort, that I wasn't planning on training her for the marathon, yet. She laughed.
    Now, why do I include all this detail? Precisely because the truth and the generality of our adventure lie in the detail. As well, my learning and growing in this experience both happen in the detail. My feeling is the most important service this journal and site provides is realistic encouragement for other caregivers out there. We really don't need greeting card sentiment, diabetically sweet inspirational poetry, vague, pretty platitudes and invitations to see our loved ones ensconced in exaggerated romantic visions. What we need to see, hear about and talk about is the dirt, the gritty detail, exact descriptions, how we deal with it, what we learn as we deal, how enspirited we feel and how our perspective enlarges when we've dealt (either successfully or unsuccessfully) with yet another back street circumstance. I know from experience that there is nothing more inspiring than working in and through that dirty detail. It's something all caregivers come to know.
    Lastly, refusing to hide the dirty detail of caregiving adds a measure of dignity to our loved ones that cannot be granted in any other way and, finally, produces the most inspired and inspiring experience of all: Seeing life, in all its guises, as awe inspiring and awe-full.
    When we caregivers talk dirty detail, listen to us. I promise you, if you listen to the end, it will be more exhilarating than a million glossy greeting card sentiments.
    It's late. I need some sleep. I want to be able to greet whatever might happen tomorrow refreshed and able to be completely absorbed in another day of this amazing journey.

It's late, I know...

2003-08-16T13:04:00.001-07:00

...and I've only managed to input one of the nine remaining blood test results, those for 12/20/02. I figured out a lot of things from posting this one, though, which are 'precipitating' the 'event' of me making some global changes to test results already posted and to be posted.
    First, I finally got it regarding the Reference Range for Blood Glucose. Regardless of whether a patient is fasting, the range for a CBC from this lab (or, perhaps, from the manufacturer of the test) always reflects the fasting range. There is an area on the results that tells (accurately, I hope, although I will be checking this, too) whether or not the patient is fasting. I just never noticed it. I figured this out from looking up some information on Blood Glucose in order to answer a question I had about whether it was normal for one's Blood Glucose to vary out of fasting reference range during the day as one eats and digests foods, and, if so, what those ranges are for diabetics and non-diabetics. I haven't found all the information, but found enough to realize that, at least for diabetics, yes, blood glucose varies and there are appropriate ranges for the variations as well. As I gather more information on this I'll post it. Since my understanding of this is increasing I will be adding all Mom's blood glucose readings to her already posted and to be posted test results and time of day of the draw if that information seems pertinent.
    I also noticed that the Hemoglobin A1c test is ordered separately so I've given it its own table and will be changing this in all the other tests. Depending on what other tests have been ordered, it tends to show up all over the map and I have been inserting it in whatever table it happens to follow, which can be confusing. As well, to each of these tests that has the American Diabetic Association Guidelines for these results posted I'll add those as well. So far, these appear on only two test postings.
    I have to mention, I love going over and posting these test results for a couple of reasons. I like learning the language, it is so provocative. I love what it adds to my overall language acuity and my penchant for playing with language. I also like what I'm learning in regards to body and health indices, etc., and how these things cause my mind to take flight. Frequently when I am doing this (as is often the case when I am doing other life things, as well) I feel enveloped in a very gentle, firm feeling of being surrounded by what I call god/God/All, as this essence smiles encouragingly around me, telling me, "Learn as much as you are able. Think as much as you are able. Create out of it as much as you are able. This is how I am known and how I evolve."
    This morning I've also been considering, as I concentrate on the test results in light of My Mother's Revival, that my standards of assumption for what is and isn't possible in regards to age (especially old age) have needed much revising. I now am thinking that at any age with motivation (and, I suppose, without, as well) startling changes and startling growth are possible. In my mother's case I am the primary motivation but as we continue from here I will be happy for that to be augmented with the motivation I expect her to glean from being out more, moving more, thinking more, seeing more, maybe even hearing more... I am excited about where and how this all might propel her. It's happening slowly and I'm not going to push it but, damn, it's amazing to me that we've even gotten this far. Maybe we shouldn't so easily give up on those who seem entrenched in their aging bodies. Maybe they aren't entrenched by their bodies, maybe their bodies are, in many cases, reflecting the entrenched thinking of those around them (or, for that matter, not around them).
    Lastly, I've been doing much reflecting this morning, as I post test results, about my relationship with my mother's doctors, especially her PCP. I am pleased to consider how dynamic our relationship is, how none of us (in most cases) flinch from disagreement with the other, how we are all strong in our opinions as well as willing to have our opinions challenged and how readily this very active dynamic works to help my mother and to help me better care for her.
    It's a good day today. We're preparing to go out and do a little shopping for minor grocery necessities and a new Scrabble game (our old one's alphabet has been decimated over the years). Who knows that will happen next?!?

All imaging test results that I acquired...

2003-08-16T02:00:00.001-07:00

...from Mom's PCP have been posted and uploaded. Added to what I mentioned earlier are two Echocardiograms and a Carotid Sonogram. I also made some corrections to a few previously posted and uploaded tests as follows:

The CT of Chest Without Contrast that I earlier reported as having been taken on 9/22/02 was actually taken on 9/27/02.
I added commentary to the Chest X-ray taken on 9/17/02, placing it by precipitating event and connecting it to the CT of Chest Without Contrast taken on 9/27/02, as this test precipitated that test.
I got a full copy of the blood draw tests taken on 9/17/2002 and was able to fill in two values for Hypochromia and Ovalocytes under the Slide Review/Morphology portion that had been cut off on my earlier copy.
I changed the date of the blood draw test previous reported as 5/23/03 to it's correct date of 5/22/03, which had been obscured on a previous copy.

    I still have nine fluid (blood and urine) tests to post. Fluid test results typically take longer to input than the imaging tests and are a strain on the eyesight so I'm going to defer those to next weekend.
    I'm thinking in terms of soliciting all the reports that Banner Hospital has on her that were taken during her brief stay last fall, any reports from her hematologist that I don't have (I think I have most if not all of them, actually), and any formal hard copy reports from the gastro-enterologist who performed her colonoscopy. I'm going to defer that, too, until we return from Prescott in the late fall, as we aren't up there yet and, now that Mom is released, as soon as our refinancing is done I think we could use a doctor/lab test result-free couple of months.
    There are also two medication changes to report. As of yesterday her PCP decided to lower her iron dose from two pills per day to one. As well, he suggested moving the one 2 mg Detrol from morning to night rather than prescribing a 1 mg Detrol tablet twice a day. We started both of those changes today. I will update her medication schedule this weekend.
    She's been looking and feeling good today. We played Yahtzee tonight for the first time in I can't remember how long. She had trouble remembering how to play at first and needed frequent reminding but came round nicely toward the end and "let" me win two out of three games.
    There are also going to be some interesting adjustments regarding her eating habits. The better she feels the more she wants to eat but I think by increasing her activity we should be able to take care of some of that. Not that I don't expect her appetite to increase as she becomes more active and feels better but I'm beginning to think that her problems over the last year or so have been accelerated in part by a vicious cycle that she fell into and I didn't catch in time as she developed anemia: Lethargy drained her alertness, increased her snacking (out of boredom), which increased her blood sugar, which increased her lethargy...and pretty soon we were in crisis mode. I do not believe her anemia was caused by the cycle but now that we are beginning to control it, despite not yet determining its cause, I want to avoid her slipping into this cycle again and aggravating all her other manageable conditions. We've talked about this on and off over the last week and I've begun to slowly institute measures that will help keep her alert, active and as healthy as possible. Emotionally she is not pleased, but she understands the thrust of these new strategies intellectually and I think with a careful eye and much good humored repetition from me she will accept and eventually welcome the changes, just as she did winnowing sugar out of her diet. I expect this means we'll be operating as a team, once again. I can't wait!
    Later.

Through multiple interruptions...

2003-08-15T18:30:00.001-07:00

...during an altogether normal afternoon, I have only managed to post 4 old test results, three of which are imagings and one of which is a pathology report on the cancer removed from Mom's left arm, which I will upload at this time. All of them are listed for handy access on Mom's Test Results page.
It seemed appropriate to include some commentary on why the imaging tests and pathology reports were administered, which I've done. I'll continue this policy if I can remember why each test was done.
It's time to prepare dinner. I hope to get back here later this evening and add more test results. We'll see, though; I am a multiple interruptions type of girl.

Quick note:

2003-08-15T14:51:00.003-07:00

Although I intended to wait until I'd posted all the test results to publish them the first one turned out to be interesting so I am going to publish it now. It is a duplicate CBC taken on 8/08/03 from the same blood draw, different vials.
The explanation for this duplicate appears above the results for the second CBC. The two sets of results, taken together, imply an interesting lesson in blood chemistry and blood test technology, if you're into that kind of thing and have no technical medical training. I am and I don't.

My mother occasionally slips into...

2003-08-15T13:32:00.000-07:00

...what I call a "contemplative zone" in the morning or when awaking from a nap. If, as today, we have 'places to go and people to see' I have to jog her out of it. I have a routine involving a short series of questions that always works and usually yields an extemporaneous comedy routine. Today, though, her answers to the last few questions gave me reason to pause and do a little of my own contemplating:
    Me: What are you contemplating?
    Mom: Life.
    Me: And what have you decided?
    Mom: Yes.
    Life. Yes. Good idea.
    I'm glad she is still contemplating life from a "yes" perspective. I know, someday, the answer will be "no". At some point, for a variety of sub-reasons and one master reason, we all finally (pun not intended but appropriate) say "no". We have an automatic "no" built into us and as yet have not figured out how to short circuit it. It's possible we never will, because the structure of this existence appears to be built on a yes/no axis. When my mother reaches the opposite pole I intend to face it with grace and magnanimity. But until we get there, hearing her say "yes" to life inspires my spirit.

    I'll be spending the bulk of this afternoon posting and uploading past test results. I may not get them all in today but I'll keep at it over the next few days until I'm finished. Then my intention is to finally address the last issue with which I am still concerned in regards to the previously mentioned Beliefnet article.

We just returned from an appointment with Mom's PCP...

2003-08-14T13:05:00.000-07:00

...and it looks like we're good to go. He's "very happy". I'm "very happy". Mom's "very happy". There are a few things I want to report but I'll take care of that later.
    In addition, I do now have copies of back test results and I'll be posting those as I can. I'll mention here each time I end a session of test posting. While I'm thinking about it, I know I still have some history to go but that's coming along very slowly...I haven't yet gotten everything I want to include from 2002 and 2003 for auto-sort/date/upload yet.
    I've got some stuff to do. I'll be back later to work on the last posting reaction to the Beliefnet article mentioned below or, who knows, something else. It seems like I'm always a few postings behind my intentions but, considering all the wordsandwordsandwords I type here, I don't think anyone minds.
    Later.

More info from MCS regarding Big Guns test results:

2003-08-14T09:43:00.000-07:00

Protein in the urine can come from many sources in a non-clean catch. It can come from the vagina, rectum, external genital area, and of course the urinary tract. Since it was a non-clean catch there is really no diagnostic value in it. If Mom was a little dehydrated when the sample was taken...

She is almost always a little, or more, dehydrated when the sample is taken, despite my efforts to pump her up. She was more than a little dehydrated on 8/08/03; so much so that I was pushing water on her relentlessly, even at the lab in the waiting room, and purposely took her in for her draw later in the day than usual (even though I figured she'd register high on blood glucose, which, amazingly she did not) in order to give myself some time to hydrate her, but, well, who knows why, for some reason she just wasn't retaining water that day.

...the protein was there because of that. Also the very beginning of the urine stream and the very end of the urine stream tend to be the "dirtiest" just because of contamination of the area or because a person forces the urine out at those times. If she had any irritation in the vagina or urinary tract the protein was present because of that. At 86 she has experienced uterine atrophy which will tend to cause irritation (even if she is unaware of it) and this could be enough to cause protein in the urine. Of course there are some conditions and diseases that cause protein in the urine, but these are always accompanied by more symptoms. On the whole I wouldn't worry about this unless you feel that the catch is a clean one. Be sure to tell the doctors that this was not a clean catch sample.
I just read a report that 1 in 10 older adults have protein in their urine. This could be because the filtration of the kidney wears out (especially in diabetics) as a person gets older. One reason the Dr. asked for a protein test on the urine is that it is a good way to access kidney damage - in Mom's case due to the diabetes.
There is a way of obtaining a cleaner catch without trauma - let Mom clean herself with water and a paper towel or a towelette provided by the Dr. Then tell her to start peeing in the toilet - let the first part pass, then catch a middle portion and let the end portion pass. It's messy, but it does provide a cleaner sample.

Been there (literally, "hands on" been there, so to speak), done that. Sometimes this does work a little better. The negative urine results may very well have come from relatively successful tries at this but most of the time, by the time Mom or I have finished cleaning her, she has peed away everything in her bladder and we are back where we started.

Boy, I can't believe how much I wrote about pee. Hope I didn't bore you.

Actually, discussing Mom's elimination habits and products has become one of the more fascinating topics of conversation for me these days. I think, in this respect, I am in league with parents/caretakers of children (before they get to the "pretend you're not my parents/pretend I don't have parents" age).

As far as the low IgG - I agree with you about the different ranges. It all depends on the type of test done, the machine used, the reagents used and the range that comes with the particular test kit. It is so hard to go from one facility to another because each facility uses its own testing kits. When you have Mom tested in Prescott you may find differences in the results for this reason, but don't worry, it's just a difference in facilities.

Apologia to my reaction to caregivers taking care of themselves:

2003-08-13T12:19:00.000-07:00

In some important ways my caregiving situation is unique, critically coloring my attitude toward advice given to caregivers to take care of themselves:

In my situation with my mother I am a first-time intensive caregiver. I have never been married, have not raised children, have not sought primary outlets by tending to others. I have, in fact, been so fascinated with myself, my interests and the development and practice of my skills and abilities that I tend toward, and prefer, solitary pursuits to social pursuits. From the time I left home my primary (and, sometimes, exclusive) caretaking tasks have been devoted to taking care of me.
Even in intimate relationships, although I am known as a caring and caregiving friend and lover, it is rare that I 'sacrifice' (meant in the negative) myself to others' needs. When I slip into this mode I am equipped with an internal Early Warning System developed by virtue of having been extremely independent. This has sometimes created a problem for others but it is rare for me to solve this problem by taking on added caregiving tasks if it means I will have to sacrifice (again, meant in the negative) anything I enjoy and find useful about myself and my life.
Thus, I think there are many ways that my situation, if handled by someone else, would overwhelm another but does not overwhelm me. As well, my learning curve in this adventure has been steep because I have lead an adamantly self-possessed life. There are many caregiving tasks and attitudes that I do not take on because my Mom & Me Adventure is my first intense adventure in caregiving, so I hadn't previously (and continue to try not to) developed any automatic caregiving habits that threaten to undermine my sense of self.
As well, there are many caregiving tasks and attitudes which are habits to other lifelong caregivers that I have had to learn while giving care to my mother (and am still learning) and which I welcome as they expand my ability to extend myself to others.
When I am overwhelmed in this adventure it is often because I find it necessary to learn how to deal effectively with areas of life I have, up to the point at which I became my mother's companion, avoided in order to keep my life as simple as possible; i.e., dealing with the business world on a sophisticated level and negotiating the healthcare-industrial complex.
When I become overwhelmed by the personal demands of my role as companion to my mother, which has happened a few times, I am typically clumsy in my reaction and can be counted on to exhibit ludicrously bad behavior. I am, at this time, laboring under the sad and disturbing consequences of one of these episodes that I perpetuated on MFS. As usual, I am handling the fall out in my typically self-possessed way, which may or may not be aggravating the situation, I haven't figured that out. One aspect of how I handle being overwhelmed is sure: Even as I wince at, apologize for and try to make amends for bad behavior on my part, I don't, as well, perform a 180° turn in the attitudes and perceptions that underlie the behavior. This stubbornness on my part causes problems. Although I'm living through some of those problems now, I'm still unsure of how to deal with them except to acknowledge the freedom the other person in this drama has to react in her most comfortable and most protective way. This particular learning curve is not only steep but rocky but, at the moment, being done in forced seclusion. Lucky for me I've always preferred climbing to descending.
Because of the uniqueness of my life and the place my companionship of my mother takes in it I am more apt to experience what others would consider onerous conditions as interesting and live through them with involvement, zest and the expectation that they will enhance me rather than shrink me.
Because I am in the habit of insisting on "doing my thing" I haven't been prone to 'sacrifice' (meant in the negative) my interests. When I find myself having to do this it doesn't bother me. I don't consider it 'sacrifice'(meant in the negative), as I only do it when necessary and I have confidence in my ability to determine "necessary" circumstances.
One such circumstance occurred last fall when I was granted, through MFS and MPS, some time to prepare quickly for a class I was planning to take and to which I was looking forward. After attending two sessions of the much enjoyed class my mother's health took an extreme downturn and I chose to pursue intensive medical care for her in another location, which put me out of range of the class. I have not experienced any regret over having to do this (although, it should also be noted, for some unknown reason of which I am very grateful, I am mostly immune to regret, both on behalf of the actions of others toward me and themselves as well as my own actions toward myself and others). I expect at some point to be able to either take the class again or pursue the subject in another out-of-mother-companionship method. I look forward to this but I absolutely do not resent that last fall turned out not to be the right/ripe time. This is pretty much how I handle all events that many long term and much experienced caregivers might consider frustrating.
Since I have always considered my self (separation of those two words deliberate) the most interesting aspect of being alive and have always been fascinated with my own thoughts, feelings and reactions to life, I have no inclination, at all, to bury my self, in any way, in anyone else, including myself. Surrender, yes; it is my favorite way of coming to understand people, situations, life et al. Bury, no. I figure if I bury my self there is nothing above ground for me to surrender. Surrender, for me, is an active, rather than passive, activity.
As a natural writer I have always journaled, both internally and in "hard copy" (which is to say, for the world, either orally or in written language). Thus, I can attest that journaling is one of the very important and nourishing habits of caregiving, but I don't stop there: To me it is one of the very important and nourishing habits of living.
My situation with my mother is also unusual in that her income allows me to be her caretaker without also having to hold down a job outside the home. I worked outside the home by choice in our first years together, first full time then part time then, for awhile, from our home. Now it is best for both my mother and me that my only productive engagement that would normally be referred to as work is being my mother's companion.
Because of all of the above, I believe I am in a uniquely qualified position to determine, not only for myself but other caregivers who are, unlike myself, life-long caregivers (and most likely women), when the very common scoldings of today directed at over-taxed caregivers tip the scale from appropriate, helpful advice into yet another attempt to put the responsibility for all aspects of caregiving exclusively on the caregiver instead of scolding those who are taken care of yet perfectly capable of the tasks of caregiving to others (including their caregivers).
It is interesting to me that both camps, the caregivers and those either not care taking (usually, they are being taken care of) or those giving care in very oblique (and sometimes questionable) ways, have a tendency to feel overwhelmed with this issue and are almost impossible to scold into compliance. Yet we, as a society, choose first to scold the caregivers, who are least likely to argue because of their extreme level of overwhelm-ment and the years of socialization designed to prepare them for "taking it".

I'll be back later to write and post my specific reaction (although, I notice, I've covered one of those reactions, already) to issues raised in the Beliefnet article Caregiver! Take Care of Yourself! by Debbie E. Mandel.

Information from MCS regarding Mom's blood test results.

2003-08-13T10:23:00.001-07:00

Quoted from her email to me:

I looked at the blood results and to me it looks good. The RDW is a percent of the size distribution of the red cells. It will vary as new red cells are released with abnormal sized red cells such as too small or too big, and with nucleated red cells. As nucleated red cells are released they are larger than the regular red cells. The maturation process for red cells makes them grow smaller until they are the regular size. The indices [MCV-MCH-MCHC] for the blood look good. The cells are individually the right volume and hold the right amount of hemoglobin. The hematocrit is within range, but a little lower than I might expect. This could mean that there are some smaller cells in the blood along with some larger cells, too. They would pack more -- smaller crit; and there would be a wider range of cell sizes - a larger RDW.
What does this mean? Maybe nothing. It could mean only that her bone marrow is kicking in to correct the anemia. The low IgG could be caused by the allergies she has right now. The eosinophil count (%) is at its upper limit so I would guess she has hayfever. IgG levels can be depressed by allergies or asthma. Unless the doctor says something about these I wouldn't worry. She looks good to me! By the way the urine IFE test that Mom had was also a test for multiple myeloma - she didn't have any indication of it.

Thank you, MCS! "I am truly happy, three times happy," [Llama Norbu, Little Buddha] and three times blessed, in a variety of unique ways, dependent on the uniqueness of each of you, in my sisters.

It has been impossible for me not to continue...

2003-08-12T18:13:00.000-07:00

...musing about my mother's lab results. I continued a search on WebMD and discovered that the low range reference for IgG is 640 there (with the caveat that lab reference range values may be different) so I guess that's why Mom's hematologist didn't mention anything about it.
    Regarding her elevated RDW, after more thinking I remembered that as anemia alleviates blood numbers do not snap into place like stretched rubber bands. It takes awhile for blood numbers to normalize. My guess, looking at the rest of her numbers, some of which are just over the range border, is that he is not concerned about this one as he expects it to settle into normal reference range.
    What I read about protein in the urine, though, puzzled me. It is typical of, among other things (none of which apply to my mother), damaged kidneys. This is not the first time protein has appeared in her urine and at much higher levels, almost three times today's level in January. Yet in other urinalyses to which he referred (of which I do not yet have copies) she has bounced back and forth between negative and positive. According to his records, her last test for protein/urine/random was negative. As well, all her kidney numbers are showing no indication of kidney damage and haven't, even as they have signified her anemia.
    My mind boggled from lack of sleep and working these curiosities over so, when my mother laid down I decided to do the same. Within minutes a possible answer to the mystery of protein in her urine came to me: She has never had a clean urine test. Unless she were to be catheterized it is virtually impossible to get a clean urine test from her for more than a few reasons. Let me describe the process of what has happened every time a urine sample has been required of her since she began seeing PCPs from this particular office:

Into the bathroom we go, where ever we're at (this has also happened at home where we're often, finally, sent to collect the sample). Invariably, if she pees alone, regardless of where she is, she holds the cup in her hand and forgets to take the sample. I've learned that I have to take the sample.
She claims she can't pee. While she is claiming this her urine stream begins, often unbeknownst to her.
I shove the cup (which she has trouble managing) between her legs, usually grazing her skin at least a few times, hunting for the stream, finding it and getting what I can.
As far as the wipes provided for cleaning the area around one's urethra and, for women, the entire genital area are concerned, every time we've attempted to use them, by the time she is or I am done "wiping" she has peed out any urine she was holding. We don't bother with that, anymore.
If I've only been able to get a little urine and we are at a medical facility I take the sample out to show a lab tech and ask if that is enough (depending on the type of urine tests requested sometimes it is).
When, for whatever reason, we have no luck, we take a sample cup home.
The process described above occurs at home with one difference: I follow her around until she alights on the toilet and quickly shove the cup under before her bare butt has hit the seat in order to gather what has already begun to flow.
If we are unsuccessful we keep trying but, typically, there is a time limit on how long the lab will wait for a urine sample if they already have the blood. We have, on occasion, been told "a urine sample is no longer needed", which is polite medical code for, "forget it, maybe next time, or, maybe the blood work will show that a urine sample is unnecessary."
As far as the technique for guaranteeing a "clean" urine sample flowing through her body is concerned, which consists of one emptying one's bladder completely, drinking several ounces of water and waiting for it to flow through then allowing a bit of the stream to be voided before filling the sample cup, well, medicine can forget that we'll ever again be able to do this.

    As I was mulling over these details and trying to drop into Nap Waves it occurred to me, considering all the skin cells, vaginal secretions and whatever is in her underwear that leaves its mark on her genitalia, probably some of that stuff contains protein. I wonder if this is where her curious protein readings, which never show with any kind of regularity, come from.
    I wish I had thought of this when I was talking to Mom's hematologist. I know that he would not have dismissed my idea out of hand without explaining to me why this couldn't possibly be the problem, if it couldn't. Although I remain dedicated to her PCP he tends to get himself into overbooking frenzies and doesn't consider my questions. Sometimes he doesn't even answer them with a mere, curt "yes" or "no". If I catch him on an easy day I can carry on a reasonable medical conversation with him. If not, he has a tendency to pooh-pooh anything I say. Sometimes, though, I find out later that I am right or my ideas have merit, usually from another doctor and in arrears, as with the colonoscopy. I'll see what he says when I talk to him on Thursday. I may go back to her hematologist with this idea, later.
    Something I forgot to record that is important: I mentioned to Mom's hematologist that she responded with amazingly restored vitality to the accidental colonic preceding the colonoscopy and that the effects, although somewhat modified, have lasted. "I'm thinking," I said [as I had mentioned to her PCP during one of his high frenzy days] that when lethargy returns for more than a few days and I can't seem to revive her by other methods, of administering light, modified bowel cleansing from time to time."
    When I mentioned this he was hunched, head down, over my mother's numbers. By the time I finished he had fixed me with bright eyes, was smiling and responded, "Absolutely! Good policy!" and lifted an upturned thumb in the air, which is a bit out of character for him being that he is a reserved man.
    I guess I'm right on that one, too. I wonder how many other of my ideas have been right but haven't been acknowledged as such because other doctors (her PCP isn't the only violator here) simply haven't had the inclination to listen to and consider what I have to say.
    Doctors and patience. That's where this post needs to go. I had originally intended a free standing essay on this topic. Perhaps I'll collect all this stuff onto one page for convenience, adding what I have already written. The story never seems to end. Maybe I shouldn't be writing an essay but a free flowing litany on this subject with it's own page.
    Dinner time is approaching so I continue not to have time to concentrate on my second posting regarding the beliefnet article. Maybe later tonight. Maybe early tomorrow. We'll see.

New Test Results - Good News!

2003-08-12T14:32:00.001-07:00

    The test results have been posted for draw date 8/8/03. Almost everything looks good. Her RDW is high, which I need to look into, and her protein/ urine/random came back positive (it should be negative), which was a mentioned concern of Mom's hematologist. I'm wondering about her low IgG, but he didn't mention it and I didn't have the lab results to actually look at until he spirited out of the office. Over all, he pronounced Mom as no longer suffering from anemia, was very pleased with her progress, was torn about whether to "cut [Mom] loose" or have her come back but finally decided to write her PCP a note about the positive protein/urine/random result and have us come back on February 17, 2004 at 1100. I'm writing that for my own reference and to help paste it into my conscious brain.
    Her weight was stable at 150 (although, it looked to me like 149 but the nurse couldn't decide and went for 150). Her blood pressure was "a little low," said the nurse, at 102/62. Her pulse was 80 and her ear temperature was 97. I took it this morning because she felt so warm but her warmness was a result of snugness in her bed and I measured it orally at 97.1. Seems a little low to me but no one mentioned it.
    The hematologist greeted Mom by mentioning that he was pleased to see her "big smile" and Mom responded, "I saved it for you."
    He smiled back and said, "I'm blessed!"
    Later he mentioned Mom's smile and I teased him (and her) and said, "It's her secret weapon." He agreed.
    There were two changes I noticed in Reference Range numbers since 1/23/03 (the last time this particular battery was ordered on Mom). The upper calcium range was changed from 10.2 to 10.4. Curiously, on her 1/23/03 test, Mom registered "high" at 10.4. Today, she registered "normal" at 10.4. As well, the potassium/serum Reference Range was changed from an upper cutoff of 5.1 to 5.2. This is bizarre. I'm going to call MCS, let her in on the good news and ask her whether this changing of reference ranges is typical.
    I checked WebMD for information on high RDW (Red Cell Distribution Width). This is what I found, with the portion underlined, by me, that appears to apply to my mother (except for the fact that her hematologist seemed not to take note of it and pronounced her "no longer anemic", anyway):

One commonly used method for classifying anemia is to categorize the anemia by the size of the red blood cell as measured by the mean corpuscular volume (MCV). Microcytic anemias are associated with an MCV less than or equal to 79 femtoliters (fl) and include iron-deficiency anemia, thalassemia, and anemia of chronic disease. Macrocytic anemias are associated with an MCV greater than 101 fl and include anemias related to vitamin B12 or folate deficiency, myelodysplasia, and liver disease. Most anemias are normocytic, meaning that the MCV is in the normal range. This category includes myelophthisic anemia (anemia due to neoplastic replacement of the bone marrow), most chemotherapy- related anemias, anemia due to renal or hepatic dysfunction, hemolytic anemia, and aplastic anemia. However, a mixed red blood cell population consisting of both microcytic and macrocytic cells (anisocytosis) may indicate a combined etiology, for example chronic blood loss (microcytic) with resultant reticulocytosis (macrocytic). In this situation, the MCV may be in the normal range, but the red cell size distribution width (RDW) would be elevated."

One more mystery to be solved.
I'll be back later...to ruminate on the plight of caregivers being responsible not only for taking care of their charges but themselves as well.

Consider that I'm thinking out loud in this post.

2003-08-11T21:26:00.000-07:00

    If you've visited the What's Next section on the Updates page and perused the To Do List you may have noticed a tick to myself about checking Lisa Alther's Kinflicks "for musings about my mother's death". Although I haven't yet looked this up or written on it, this post covers a related subject; musings about the spiritual/psychosomatic origins of my mother's dis-ease of iron deficiency anemia. I was prompted to think about her anemia from this perspective by an article I read yesterday in Beliefnet's weekly email newsletter: Caretaker! Take Care of Yourself! by Debbie E. Mandel, first mentioned a few posts previous. In the article Mandel introduces a caretaker who became so caught up in caretaking for her family that she martyred her life for several years. She "became dangerously anemic and no doctor could figure out why, until one hematologist suggested, 'It could be stress. Blood symbolizes family [italics mine], and your family is stressing you out!'" Once she grieved her mother's death (the object of her original caretaking mission which led her into caretaking for other members of her family after her mother's death), married her fiance, left her family, "...let go and live[d] her own life joyfully...", including releasing her guilt for having left her family to take care of herself, her hemoglobin rose and stabilized.
    I have no reason to doubt this. I have a vigorously nodding acquaintance with the "psycho" part of "psychosomatic" in regard to my mother. It wasn't the specific postulated reasons for the rallying of the caretaker's hemoglobin count that caught my attention, though. It was the association of blood with family and iron deficiency anemia with a family who was unwittingly and inconsiderately stressing the the anemic caretaker.
    It has set me to thinking about what the psychosomatic causes underlying my mother's persistent anemia might be. As I have been thinking out loud about this, here, I've been throwing these ideas out for my mother's consideration, as well. Although there are some interesting family dynamics [lack of contact being a major one since my mother's immediate family is very important to her and now contains most of her friend network (which has been a lifelong life style for her)] that could cause my mother to feel stressed about her immediate family, we've discussed these. She doesn't feel that these are causing her any stress or guilt and I believe her. She is, always has been, supremely philosophical and phlegmatic about the ebb and flow of family relations and I've never known her to be bothered by family dynamics, let alone stressed by them.
    It occurred to me as we, bit by bit, dismissed family=blood as a source of "stress", that perhaps in my mother's case the important "psycho-" element of her anemia isn't the blood=family factor but the iron=strength factor and that her personal strength has been sapped, perhaps by a member of her family, most likely me. So, we explored this. Here's what we came up with:
    Although my mother's anemia has only surfaced within the last year (probably around August of last year), other aspects of her health have been troublesome from the point of view of her personal strength (both -somatic and psycho-) for almost two and a half years. Although this jibes, more or less, with how long she's been on metformin it also jibes with a few other circumstances:

Her health coming under severe scrutiny and treatment by doctors on whom she has rarely had to rely;
As her lethargy developed and affected her ability attend to her personal business I began stepping in and taking over. Previous to this, although I was providing the service of handling her business for her I was also discussing it with her, talking with business people with her rather than in her stead and I always allowed her final say, even if it, occasionally, got us into trouble and we had to recant. Once lethargy gained a foothold, though, she not only deferred to me, she slowly bowed out of even discussing these matters with me or anyone else. I, without question, took over, including such things as carrying all the money, paper and cards, handling conversations on my own, making decisions on my own (although I still let her know what was and is going on and solicit her input; it's just that, for some time, she's waived input), etc., even turning off the ring on the phone to make sure she did not make a decision or agree to something of which I would be unaware but would affect us profoundly later and surprise the bejesus out of me.
Her ability to entertain herself also flagged (she's always been excellent at being able to entertain herself) and she got into the habit of looking to me for the entertainment factor in her life. If you've read any of the history you know that I have a strong loner streak and tend to consider socializing as 'up time' and being alone as 'down time' (to put it another way, socializing, for me, is a type of work, although a welcome one at which I'm good and that I enjoy; my real joy, though is to be left alone to my own devices to pursue my interests, most of which are decidedly solitary). So, I haven't been the best of entertainment providers for my mother and on occasion have sabotaged her efforts to get me to entertain her.

    While she completely rejected the blood=family connection, the iron=personal strength connection made some sense to her. As we talked we began to suggest ideas for how, now that her physical health is rebounding enough for her to look forward to having energy to burn, perhaps it is time for both of us to reinvolvee her at an easy pace in the accoutrements of her life; for us once again to be partners, as is reasonable, in her and my lived-together life.
    For instance: For the past two years she has been completely uninterested in working with her accountant on taxes. I suggested that next year we should go together again. For two years we have ignored our twice yearly visit with her stock broker and she has not discussed stocks with him, even during the rather critical period when her holdings were converted to an annuity. Time for us to reinstitute this tradition, I suggested. She enthusiastically accepted both these ideas.
    For a long time we have rarely hosted family in either of our residences for any reason. Time to start doing this again, once we do the repair and remodeling that have become necessary on both houses. Great idea, she thought. We should begin again to initiate visits rather than waiting to be asked as my mother feels up to it. Yes, good idea, she again confirmed. Mind you, all this enthusiasm for involvement in her life is actually a re-enthusiasm for re-involvement.
    Before I initiated this conversation with her this evening she decided to go to bed at 2130 which is a bit early for her. I insisted, though, that she couldn't go to bed without a thorough foot and leg rub. This was a good idea, as she has begun to retain water normally again within the last 12 hours or so. While she was not overly saturated, a good foot and leg rub keeps her body from refusing to release water. It was during this foot rub session that I started the above conversation. It became so animated and involved that she didn't go to bed for a little over another hour.
    I have no idea if her anemia will improve. I suspect that her numbers, while they may have rallied a bit for the Big Guns Draw on Friday, probably weren't yet back to normal. Something tells me, though, that since our discussion tonight (especially our consideration of strategies to reinvolve her in her life and the lives of those she loves, which should automatically increase her feeling of personal strength) I shouldn't be surprised if, at some point in the next month or so, her anemia recovers. I'm not going to outright expect this...I am circumspect, so is she. She thinks the psychosomatic ideas I am proposing are a bit "out there" and I know she's not going to count on them either. But, in her words, "We'll see." I think this consideration, tonight, of in-the-blood iron=personal strength might work at least as well as the accidental colonic that the ill-considered colonoscopy required. At least I am optimistic about this.
    In the meantime we are still planning on releasing ourselves, finger by finger, from the clutch of doctors, as we've agreed, for week or so, that "it's time" for this. We are still going to Prescott and Mom seems more up for this than she has in a long time. I will continue, overtly and surrepitiously, to monitor her with an eagle eye and seek out professional consideration if I think it's necessary. And, we'll both pay more attention to her personal strength quota. It certainly can't hurt.
    Although I intended to also write, tonight, on my observations and opinions of the current social concern over caretakers taking care of themselves I think I'll put that off until tomorrow. I've got an early call in the morning. We will be seeing the hematologist tomorrow and I still have some things to do before retiring tonight. Here's a teaser, though: I've lately begun to wonder why it is that, in this country's society, overall, at this time, we are not only depending on caretakers to take care of others but, now, we're charging them with the primary responsibility for taking care of themselves. I know that the current "personal health" fad dictates that one must be responsible for one's self as one is able. When I look at it from the imagery of a set of scales though, it looks more like what we are doing, in pushing this seemingly wise strategy so vociferously, is simply moving several more weights over to the already tipped plate then blaming the person struggling beneath the plate if they can't reach up around the lip, pull some of those weights off and move them to the lighter plate dangling high above their reach. Think about it. So will I.
    If events allow I'll write more on this tomorrow.

A little felicitous news.

2003-08-11T16:53:00.000-07:00

    This morning I awoke my mother at 0830 to begin preparation for going to her regular Monday hair appointment at 1130 (I always give both of us plenty of time). Much to my surprise, she ambled into the bathroom carrying a clean bra. I should explain, here, that she wears a bra to bed, usually the bra she wore the previous day.
    Thinking she must have had another water shed night, I went the opposite way into her bedroom to change the sheets. They were dry.
    "Mom, did you sweat through your bra?"
    "No." She sounded and looked surprised that I'd asked.
    "Is there some reason you feel you need to change your bra immediately?"
    "Yes." My mother likes to tease me with one word answers. It always prods a smile out of me.
    "Okay, I'll bite, you've decided to astound the fashion world by wearing bra-over-bra."
    She chuckled. "I was planning on taking a bath."
    This confused me. It has been a couple of years since she's volunteered to take a bath, let alone immediately upon waking. "Uhm, okay, that's fine. You know, you usually bathe after breakfast..." I wondered if I should have bitten my tongue before saying this.
    "I think it's a good idea to bathe when I wake up."
    I believe I heard the angels sing! "Well, good! I agree with you. Would you like me to draw your bath water?"
    "Yes, thank you, that would be nice."
    Although the day has continued low key and I had to remind her a few times why she had bathed and turn her back from a nap 15 minutes before we were due to leave for her appointment, it has, overall, been active and she just announced, as I began this post, that she thinks she'd like to go out to eat.
    "Sounds good to me." So, I had intended to work on my reactions to a few issues mentioned in the article in the preceding post, but, damn, if the woman wants to go out to eat I think we'd better go!
    I'll be back later this evening. You can count on it.

I intended to write two more posts...

2003-08-11T01:00:00.000-07:00

...in reaction to an article I read in the most recent Beliefnet newsletter entitled Caretaker! Take Care of Yourself! by Debbie E. Mandel. I have some reactions to record to two issues raised in the article: One about anemia and how the article is provoking me to think about my mother's very persistent anemia; the other about caretakers being expected to take care of themselves.
    I spent a bit more time than I expect bitching in the previous post and I need some sleep before tomorrow begins, early.
    Just to let you know, I have not read any of the commentary on the message board accompanying the above mentioned article and I don't think I'll be doing that until after I muse about those issues about which the article is prodding me to write. I'm hoping I'll get back here some time tomorrow to post further on this topic. As well, I've asked Beliefnet for permission to quote from the article. With luck, I'll have that permission before I begin my commentary on these issues tomorrow. If not, I'll comment without direct quotes, then add those later.
    My eyelids are heavy. I need sleep. Until tomorrow, then...