Not Dinner Table Conversation

One thing about caring for an elderly parent: things that you were raised to know weren't fit for dinner table conversation are now by necessity the stuff of daily survival. Not yours. His. Not only must you discuss them regularly with your parent, you must become well enough schooled in them to impart that knowledge to a host of others who will need to know them as well.

Take catheters. For many years my father has needed to self-catheterize in order to void his bladder. He calls the catheters his "pissers". Mom dropped this information into a conversation in their living room like a bombshell a few years back, as casually as if she were discussing the price of melons. Now that I'm taking care of his needs, I need to keep him stocked with supplies and keep track of his successes and failures in emptying out his bladder.

The first is made easier now that Medicare pays for one-use catheters. No more "sterilizing" them between uses by soaking in vinegar. Just going to the medical supply place to pick up his allotted 5 boxes each month - provided, of course, that they have 5 in stock. He seldom uses that many in any given month, so there is some flexibility there. They come individually wrapped, meaning there has to be a scissors available next to them, one of a highly contrasting color to everything else so that he can find them, allowing for his poor vision. It took us months to convince him not to try to save his used catheters and reuse them in an attempt to save money. So there's a wastebasket to empty more frequently now as well. In addition, if he needs to pee in the middle of the night, he can't/shouldn't try to make it all the way to the bathroom and back, so there is a supply of catheters on his nightstand, in pre-cut wrappers, and a plastic wastebasket serving as a honeybucket. Every morning that has to be checked, and emptied, rinsed and replaced if necessary.

I learned real fast doing that not only how/whether his kidneys are functioning but whether he has another of his frequent infections, or UTIs in hospital-speak. How I tell is by noticing if the smell is enough to gag a maggot or whether it's just normal urine smell, and whether the "product" is watery or ropy.

Not exactly how I planned on spending my middle age years.

His kidneys have begun to falter, much like the rest of him. Wednesday evening he mentioned to me on his way to bed that he couldn't pee. He'd even tried 3 different catheters to see if a different one would produce different results. (No.) I asked him if he felt full or empty, and he said empty. I sent him off to bed with the reminder that it would be OK for him to use the wastebasket in his room in the middle of the night if that changed. He always apologizes when he has to do that. By noon Thursday he still hadn't needed to pee, and that's when it became time to quit work early and take him into the ER to test his kidney function and check on infections. (His regular doctor can't do that in his office. We checked.)

The kidneys of course, like every other time, kicked in again just after noon and he could pee again. But in the meantime he'd developed another UTI. So once again he has a Foley and a bag, along with a week's supply of antibiotics. His creatinine levels were moderatley elevated, but nowhere near high enough to think about dialysis. And for some unknown reason, this doctor wants the catheter removed in two days, not the two to three weeks most call for. We'll see how that goes. Won't self-cathing just promote another UTI quicker?

When he self-caths, periodically he'll say he wants a permenent Foley and a bag. When he has one of those, however, he can't wait to have it removed, after he's had a few days of exclaiming how much easier this is.

On the bright side, he asked to stay in the car for the trip to Target to get his prescription filled. He's been housebound for weeks, and enjoyed the scenery, little of it that he could see. I had been planning a weekend excursion using my Hyundai, taking him out for an hour or so, because he can get in and out of that reasonably comfortably and it has a good heater. Of course, now that's not possible. Luckily it was warm enough yesterday that his Buick managed to maintain a comfortable inside temperature for the ride - especially since it had been driven and warming up since about 8 AM. At Target I managed to park so he had a view of the entryway and the comings and goings of folks while I went in. Not exciting, but it beat the same old walls he'd been watching for months.

And yes, for inquiring minds, the Hyundai has been officially "totaled". If I ever get some time, I'll be going car-shopping.