Posted in Inside Lane

Well, This is Alarming


November 9, 2017, my son was diagnosed with strep throat and I breathed a sigh of relief. Since finding my mother, dazed and confused, I’d been trying to talk her into going to the doctor, and she had kept refusing. Having had Thor coughing in her face for days, I finally had an excuse to drag her to the urgent care. She was not happy about it, but she agreed that if Thor had strep, he had probably given it to her.

The strep test came back negative, but after three different people (an RN, a PA, and an MD) had used two different blood pressure machines and one old-school hand-pump cuff to get a read from my mother’s arm, we won a trip to the emergency room. We could have taken an ambulance if we’d wanted–that’s how high Mom’s blood pressure was. She refused.

Eight hours later, we were released from the ER with an armful of prescriptions and a referral to a GP for follow-up.

236/97

420

Those were the numbers I wrote down in my little notebook. I was carrying it with me by that point because whenever I thought of something I needed to do for my mother, I would write it down so I wouldn’t forget.

Those were the readings for my mother’s blood pressure and blood sugar when we got to the emergency room. They let us leave when they got her down to 130/82 and 236.

“I don’t know what these numbers mean,” I told the attending physician in the ER.

“They mean your mother is at high risk of stroke or death.”

“I’m not having a stroke!” My mother insisted, then started muttering about being healed in the name of Jesus.

The physician didn’t quite ignore her, but clearly, I was the one to talk to. I got a long lecture on diabetes and heart disease, but not nearly long enough because at that point in my life all I knew about either was that you shouldn’t have sugar with one, salt with the other, and both would kill you.

However, it was the first in a long line of doctors talking to me like I was an abusive pet owner, who had willfully ignored the health of my mother. I’d only gotten hold of her a few weeks prior! I’d barely gotten her to the urgent care! I knew she needed medical intervention, but you try moving a 285 lb woman anywhere she doesn’t want to go.

I ignored the tone and just wrote notes in my book. I figured I’d need that for the follow-up with the office doctor.

My mom home and tucked in bed, I went home and started scouring the internet. I’m honestly surprised she hadn’t stroked out or died. The internet was pretty sure it was impossible for her to be alive, much less mobile and communicative. So, I filled her prescriptions, bought her a day/night pill container and got to work getting her healthy.

The first step was a visit with the office doctor who expressed some surprise at the fact she had survived the ordeal. Thank goodness for strep, right? Another 24 hours at those levels and she probably would have died, he said.

I pulled out my little book and read him what I’d written, confirming the numbers I’d taken from urgent care to the ER, and the numbers the ER had sent us home with. I showed photos of the pill bottles to confirm medication and dosages, and dutifully wrote down everything he said.

When he asked me why my mother had not been on medication previously, I looked to her. She pretended not to see me. She studied the wall, her chin jutting out stubbornly. “She doesn’t like medication,” I told him. “I know she’s had prescriptions for her heart, but she didn’t want to take them. She takes…herbs.”

He hummed and made a notation. “How long has she had diabetes?”

“Erm… Mom? Didn’t Dr. Chang make that diagnosis?”

“He said I had it, but I don’t.”

I thought of all the banana splits and 2 liters she had consumed in defiance of Dr. Chang’s declaration. She took licorice root, she said, and that was enough to balance her sugars. I felt my own blood pressure starting to rise.

I said to the doctor, “At least ten years. I think that’s the last time she’s had a regular doctor. He said she had diabetes, so she quit going to see him.”

“I don’t have it,” my mother said, sullenly.

“Well, Mrs. M,” the doctor said, “you actually do. That’s probably what has led to a lot of your confusion. When your blood sugar is that high, and when your blood pressure is that high, it affects blood flow to your brain and makes it hard for you to think.”

Her attitude turned on a dime. “Oh!” She gasped. “I didn’t know that!”

“Yes, you did you old fart,” I thought angrily. “You’ve told people that yourself!”

We left there with another prescription and referrals to three specialists.

“He doesn’t know what he’s talking about,” my mother huffed as I fastened her seatbelt. “We need to go to the Vitamin store.”

Over the course of the next couple of weeks it became clear that my mom couldn’t remember how to take medicine on a schedule. There was not enough Gingko Biloba in the world. I had already put alarms in her phone to tell her when to go to breakfast, lunch, and dinner, and I was afraid more alarms would confuse her.

After several failed trials, this is what I came up with that worked:

First, on the advice of my cousin, I bought my mom an Alzheimer’s Clock.

clock

This clock would show her the Day of the Week, the Date, the Time, and the Time of Day.

Next, I bought her a pill case that alarmed and chirped at her.

pill case

 

She was sure she could remember her morning medicine, so I put her nighttime pills in the case and set the alarm to go off at 8PM. I put the pill case in front of the clock. She would be able to look at the clock, see the Day, match it to the day on the pill case and medicate herself.

For her morning medicine, I took ziploc baggies and taped them at eye level to the cabinets above her kitchenette. I wrote on each bag: Day of the Week: MONDAY, Time of Day: MORNING. And, this worked really well until it didn’t–so, for about a year once she got into the habit.

For us, the biggest problem was that my mom just hates taking medicine. She doesn’t believe in it. We struggled for a long time until I lost my temper and asked her if she wanted to see my son graduate from high school. She said she did. I asked her if she still wanted him to come and visit her after school (she lived across the street from his middle school and he could walk over.) She said she did.

I told her if she didn’t take her medicine, she would die before he made it to high school, and if she didn’t take her medicine, I wasn’t letting him come over alone because I didn’t want him to be the one to find her cold, dead body. Whatever Vascular Dementia had already done to her brain, those words made it through the squeezed out blood vessels and she heard me.

And, until she just wasn’t able to manage it for herself anymore, she took her medicine. Getting her to the appropriate doctor visits, though, that was another story.

 

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Posted in Explaining the Strange Behavior, Family, Inside Lane, relationships

My Mother’s Keeper


You’ll notice I haven’t posted here since September of 2017. I hadn’t even realized that until I came to make this post, which works out because the reason I stopped posting is also the reason I’m coming to post today: My mom.

On Facebook, I’ve been sharing a lot of the journey I’ve been on with her declining mental health over the past two years, but especially the past three months, and I’ve had so many people reach out I decided to share with a wider audience.

So, let’s start in September of 2017 and I’ll get you up to speed.

Actually, let’s start in October of 2008, when my mother was recovering from colorectal cancer in my home and I realized I was not a nurse, I was not a natural-born caregiver, and my mom was a double-fisted handful of impossible to please when she’s ill. I mean, I already knew that last part. I had remembered that from my childhood. What was new was realizing that my patience level had changed.

In October of 2008, my son was three, my husband was working full time and going to school full time. I was also working a stressful, full-time job, caring for my little family, and then driving 1.5 hours every night ONE WAY to visit my mother in the hospital, until I brought her home after a series of events in the hospital nearly killed her.

I learned that I had the patience to be my son’s mother or the patience to be my mother’s caregiver, but I did not enough for both–and that’s probably the healthiest realization I’ve ever come to and set me up for success in the following years. I don’t feel bad about that. I have limits and I know what they are.

From 2008 through 2014, at intervals, I would ferry my mother to and from appointments in order to be the detail-keeper. I took her to the MRI appointment when she took 3x the dosage of valium they had suggested and then behaved so cruelly and so badly that I chose not to connect with her for a couple of weeks after I was sure she was back to normal. (She needed the MRI because in a bout of what was increasingly erratic behavior, she had “playfully” charged my son like a bull, tripped, and busted open my front door with her head, pile-driving my then-7-year-old first-grader into a flight of stairs. She hit the door so hard, it knocked out a chunk of drywall when it hit the wall. A couple of years later, while “playfully” grabbing at my son, she would trip, fall, and break her arm.)

In 2014, when she had open-heart surgery, I reprised my role of caregiver both before and after her hospital stay, and was there when she went absolutely apeshit in the ICU for three days. I stayed at her house with her to help her settle in and it was pure, unadulterated misery for both of us. I couldn’t do anything right for her, and she couldn’t find any relief. My mom suffered every emotional side-effect associated with open-heart surgery, without the willingness to do anything the doctor or I asked her to do.

When we made our 6-week return to the surgeon, my mom (whose recovery had been arduous and unending) admitted that she had stopped taking any of the medication that had been prescribed after surgery because she didn’t think she needed it, and I lost my shit. I sat through the surgeon berating me for not taking better care of her, and not making sure she was taking her medication (I would ask, she would say yes, that was that.) I sat through her truculent response to his insistence that she take her medicine. And, I sat through at least five red lights on our way home before I absolutely lost my shit.

I was furious that I had spent so much time and expended so much emotional energy into her health, only to have her scoff and say she could cure herself with herbs. I was enraged that I had missed important things with my son so I could sit by her side while she recovered since she was just going to kill herself with a refusal to cooperate with the doctor after the fact. I was livid about all the pieces I had been forced to pick up before and after her surgery, and what all I’d had to give up and do just to make her home habitable for when she returned from the hospital. I had poured money, time, sweat, and a lot of tears into her health. All she had to do was take some pills.

Of course, it’s much more complicated than that. It always is.

A transient ischemic attack (or, TIA), is what kicked off the ER visit that led to the heart surgery. Now, I know that a TIA can also kick off or kick up levels of Vascular Dementia. With the 20/20 vision of hindsight, I can see that in the weeks and months after the TIA, my mom’s mental health was never the same. I can see that she honestly could not understand the importance of her medication routine. I can see that the part of her mind that helped her plan for the future, and helped her reason was crippled. I can see that my mother’s current diagnosis of vascular dementia probably got its start in 2014–maybe earlier.

All I knew then was that my mother knew she had Type 2 Diabetes and heart disease, and she wasn’t willing to do the work to manage either issue, and I had a child to raise and a marriage to foster. I had to work, and I had my own physical and mental health issues to deal with. So, unless she needed me for transportation due to anesthesia (colonoscopies 2x a year) or wanted company at the doctor, I released her to her own healthcare. I worried, but I let go of responsibility.

Over the course of the next three years, I saw (but did not recognize) all the symptoms of dementia in my mother:

  • Confusion
  • Trouble paying attention and concentrating
  • Reduced ability to organize thoughts or actions
  • Decline in ability to analyze a situation, develop an effective plan and communicate that plan to others
  • Difficulty deciding what to do next
  • Problems with memory
  • Restlessness and agitation
  • Unsteady gait
  • Sudden or frequent urge to urinate or inability to control passing urine
  • Depression or apathy

I started scouting senior living facilities because I was worried about her house falling down around her, and her not being able to manage or maintain it (and also because I plan in advance like I’m playing chess with Death), and I started trying to convince my mom that she needed to move.

We fought a lot. A LOT. Our usual daily communication dwindled because her behavior was so erratic and unsettling. She was not emotionally reliable, and I started pulling way back on the time she spent with my son because I felt like she was using him to fortify herself. It wasn’t healthy for him. She started asking him to lie for her, and that was the end of that. She thought I was mean and condescending. I thought she was stubborn and killing herself.

And that’s where we were in September of 2017, when after three days of her not answering her phone, I went to her house and found her wandering around pantsless and weeping.

And that’s the day I became my mother’s keeper.