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.
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.
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.
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.