Morning Routine

Time was, I could get up at 6 and be on the road just after 7. Now, if I hurry, I can be up and out by 8. There's just more to the day's routine.

The alarm goes off at six. That's what the clock says, anyway. I keep it set several minutes ahead, rather than fussing with an alarm setting that says 5:47 or whatever. It's set to radio, MPR news. It's much nicer than waking to a loud blare. I sit up slowly, taking inventory of which parts feel how. Standing is even slower, partly because in leaning forward I also lean down to pet the dog. In static shock season, he's a bit slower to approach. I also take a bit to put full weight on the knees and get full balance. Then those first slow steps to the door, then to the outside door to let the dog out. No matter how much of a hurry you might be in to get to the bathroom, the dog gets to go out first. Then you may do your beeline to the bathroom. While there, the line-up of prescription bottles, Ibuprofin and Claritin bottles get your attention. These are the must-take-every-day-without-fail pills. The vitamins are in the kitchen and come later. Missing a day of these is not vital.

Back to the living room, where the oxygen machine gets turned back on, then to the door to let the dog back in - remind him to get his ball and bring it or it's another extra trip later when he starts hunting for it - then out to the kitchen to start the coffeemaker. If you remembered to set it up the night before, it's just a switch flip. Otherwise it's dumping and refilling. All this replaces what used to be throwing a mug of water in the microwave and stirring instant into the hot water. While you are standing there, pull down the container with the nebulizer supplies, get out two vials of the medicine, squeeze the first into the part of the mouthpiece with the red center pointing up, and finish assembly. (There's a drawing on the cupboard door. Not a lot of talent, but the gross shapes tell the story.) Keeping it upright, take it and the second vial out to the machine, hook it up to the tubing and set it in the slot awaiting use. The second vial sets on the table for now. While there, you can turn on his lamp. Up to this point, the plethora of nightlights around the area probably have lit your way quite well.

Now you may have a few minutes to yourself. You can go on the computer, pay bills, organize your lunch cooler if temperature is not an issue for whatever you're packing, throw the ball for the dog, get an early start on the news and weather. Keep an eye on the clock, however, because you are expected to show up at his bedroom door at 6:30. He will have been checking his watch. It it's the weekend, he will understand if you wait until 7 or even 7:30. If it's a workday, he starts to wonder if he's been forgotten or deserted.

It usually goes like this: turn on the hallway light, because he'll need it later. Knock on his door, open it, and say. "Good morning." Turn on his room light and head for the bed. If he answers, "Is it?' or something like that, you'll know he's been sleeping fairly soundly and not been awake the last couple hours waiting for you to show up. Otherwise you'll hear something about how many years he's been waiting for you to show up, did you fall in a hole?

Help him get his covers off, clearing all the way down to his feet so he can get them over to the side of the bed in order to sit up. He may need help with his feet. He will need help siting up, because his left side has gotten very weak lately. Ask for his right hand, and use it to pull him into a sitting position. He will have a dry mouth, but there is a little water bottle on his nightstand. Remove its cap and hand it to him for a swig to "wet his whistle." When it gets empty, just refill it at the sink and recap it.

This is often his cue to check with you on the day/date. February went like this. The first week, not much comment. The second week, he noted daily that February had already lasted three weeks. The third week, he commented that February had been lasting several months. The last week, it had taken 27 years to get to that part of the month!

He was, however, getting better at knowing the day of the week for himself without prompting.

There will be a bottle of Sarna lotion on his nightstand. While he's removing his pajama top, give about 5 squirts of the lotion into your hand, rubbing it around to spread it evenly in both and warm it up. Keep a finger or two free of lotion as he may need help getting the pajama top off, depending on how much his left arm hurts. It goes on his pillow. You now spread the warm lotion on the tops of his shoulders, rubbing it in, then continue down front - yes, you can rub gently over the lump of his pacemaker - and back to mid-chest level and down his arms to the wrists. This is why you needed the 5 squirts. While you can no longer see any surface sign of his shingles, this soothes him and helps with the low-level residual pain. Another squirt gets rubbed in on his back side from his waistband to his tailbone. (This is your chance to sit down for half a minute.) He insists there's swelling there along with the pain. I can never see it, and often have to reassure him there's no rash or redness, but this helps ease him there as well. You notice while doing this if his diaper is messy or not. If not, he'll keep it on. He hates changing it, thinking he's being economical. At the very least, the 3 x week county home health aids will see it gets changed along with the rest of his clothes when they give him his bath. I'm not sure if it's the lotion or the rubbing, but I try to use a firm hand, and he feels better afterward.

During this process, his thanks will generally be effusive. "What would I ever do without you?" is a frequent sentiment. I just reassure him he'll likely never have to find out. I don't mention that there is occasionally a morning when he's not willing to wait and gets dressed himself, though without benefit of lotion. I feel guilty enough when that happens. I don't need to rub my own nose in it.

His shirt from the day before will be draped over his walker, and unless that's gotten a major spill or something, it goes back on. He needs help getting his arms in the sleeves, and the top and sleeve buttons. He'll get the rest himself. While he's finishing the buttoning is a perfect time to peel off the fuzzy 2nd pair of socks he wears to bed to keep his feet warm. They go on his pillow. Then he stands - with at least help to balance - and peels down the pajama bottoms enough so that when he sits, he's not sitting on them. Peeling them off, you remember to grab hold of the tops of his cotton socks, pulling them up so they're snug on his feet. The pajama bottoms go - you guessed it - on his pillow. His pants are also draped over the walker, and you help him get them over his feet and the feet properly headed one down each leg. It can be interesting some mornings. Once the pant legs are clear of the floor, he stands again to pull them up. Assist in tucking in his shirt tail and hitching the back up to waist level, move his walker in front of him, and he'll finish tucking in the front of his shirt, zipping and belting.

There used to be a part of his routine here where the plastic brace for his drop-foot went on over his sock on his left foot. A few months ago he decided he wasn't going to wear/fuss with that anymore. It's sitting on the floor of his closet, but so far he's managing to lift the whole leg enough that the drop foot doesn't drag or trip him.

You are not necessarily ready to leave yet. Sometimes he leaves his glasses in the living room when he heads to bed. Other times they end up on top of his dresser. It's your job to know which, give them a quick cleaning wipe, and hand them to him to put on. A clean hanky replaces the used one in his front pocket. Make sure his Lifeline pendant is back around his neck as he's been removing it lately, much good as it's going to do in the middle of the night if it's off. Note whether he's used his plastic wastebasket as a toilet in the middle of the night, because it may need to be emptied, rinsed out and returned. We actually try to encourage his using the wastebasket if he needs to go, rather than stumbling week and disoriented around a dark house. He'll put the catheter and its wrapper in the wastebasket. They can be rinsed in the toilet and put in the bathroom wastebasket before you dump out the bedroom wastebasket. He'll also need a replacement catheter waiting for him on his nightstand in case he needs it the next night. He can't tear it open, so it gets pre-cut partway through, down at the wide end, doing the least to compromise sterility at the business end.

Now you can leave.

He'll head to his lift chair in the living room. He usually gets his room light off, but misses the hallway light switch since it's tucked behind the entertainment center. He'll want his fresh hot cup of coffee waiting for him at the chair. If he's confused, he may need help finding his oxygen tube, but fairly easily figures out which way to hook it over his nose and ears after all these month of practice. I have watched the process and to me the way to hold it seems counterintuitive. If his glasses were left in the living room, now is the time to hand then to him. Part of the ritual is to ask him how his coffee is this morning. He'll either tell you it's hot, good, or both.

Most mornings by now it's about 6:50. We have the DVR set for two hours of the local news/weather station we prefer, not to record but kind of to keep in the short-term memory. If you turn on the TV without messing with any of the other controls, you can rewind it to the start of the half hour and catch headline news and weather and traffic without commercials, because you hit the 30-second skip button until they're past. He'll check his watch when they give time checks that do not match reality, and you can just remind him that the program has been rewound that that his watch is the real time.

This is my coffee time too. This actually means mocha. I add cocoa mix before I pour in the coffee, leaving just enough room at the top to about 3 ice cubes after the mixing is done. I can't drink it hot, and there's not time to wait for it to cool. The reason for the cocoa it because of what I do next: dispense the vitamins from all the bottles on top of the microwave. There's a multi-vitamin, C, D, Omega 3 (2), potassium (4), glucosamine chondroitin (3), baby aspirin, and tums (2). I can't take them with plain coffee. My stomach needs something else in it to coat it, and I never eat until I'm on the road. There just isn't time. So all these get taken over to the chair next to his, and we sip coffee together and watch the news and weather. Occasionally I'll pause it for a comment on what they just said, or to answer a question he has. When they show the national weather map, I'll tell him what the high will be in Arizona that day. (Actually, they show Las Vegas, but I figure it'll be the same temperature somewhere in AZ that same day.) If it's only in the 60's or high 50's, he'll joke that they must think it's jacket weather down there. He should know: he and Mom wore jackets for those temperatures when they spent winters down there.

Once we've gotten the weather report, it's time for my shower while he takes his nebulizer. I know for the next several minutes he won't need to be in the bathroom, but I double check, just in case. If he's gotta, it's now. If it's cold outside, meaning chilly inside for him despite the higher setting on the thermostat, he'll slip into his sweater now. Lately he needs help with that - again, the weak left side. His shoes will be sitting next to his chair. With their velcro tabs, he can get them on/off himself.

Once I'm out of the shower, it's usually time to fix his breakfast. Somehow I got smart enough 20 years ago to get wheeled chairs for the dining table. They were $150 each from Sears, and it seemed like a fortune at the time, but I was down to three from the old set. Most of breakfast can be fixed sitting on one of them. It's always the same thing. Pull out bacon, bread, jelly, OJ, and a cup of fruit from the 'fridge. Get his special plate and cup from the cupboard or the dishwasher, if that's where the clean ones are. Dig up a teaspoon and a butter knife. Lastly, tear off two paper towels from the roll.

Fill his glass halfway up with OJ, and set it in his spot at the table. While there, open the pills holder and dump out that morning's pills into the little red paper cup left there for that purpose. There'll be a Tums in the group. Set it between the cup and OJ glass on the table, where he can see it. He can swallow the whole cluster of pills at one swallow, but likes to chew on the flavored Tums after his breakfast, almost like dessert.

With the juice pitcher and glass off the counter, there's a bit more working room. Pull out a single slice of bread for the toaster, but make sure the timing control points straight up. Somebody in this family likes to set it way down, and if you don't notice, you wind up having to toast his slice twice. Fold the paper towels together, then in half. Two half-slices of bacon go in the miffle of the towels, with each side then folded over. When you place this upside down in the microwave, you have almost the perfect amount of towel to catch all the grease that cooks out. A minute and a half gets it just the way he likes it: hot and curly but still mostly chewy, not crisp.

While bread and bacon are cooking, the cap comes off his fruit cup (these are the lunchbox servings, sold in 4-packs or 6-packs.) Drained if necessary, it goes on his plate, along with a spoon. Note that his plate is one of those old melmac plates given out years ago on airplanes. My exceedingly thrifty mom saved every one of them. They're handy now because of the raised rims and small size. They hold a perfect portion for him and keep it from ending up on the table while he searches for his food with his extremely poor vision. The finished toast gets spread with Paul's homemade jelly, whichever flavor happens to be handy, then cut in half and turned into a bacon sandwich, after you've patted down the towel around the cooked bacon to soak up all the excess fat. Be careful to throw the towel away under the sink where the dog can't dig it out of the trash. If you call Daddy to the table as you're spreading the jelly, the timing is just about perfect for him and food to arrive at the table together.

He will bring his coffee cup over to the table while using his walker. If you're lucky, it was mostly empty before he started out. At any rate, it will be by the time he gets to the table. I fill his cup after he sits down and take it back to his living room chair for him to drink after breakfast. I also turn his walker around so it's facing him after he stands up to leave. He never remembers to do this, so he winds up standing and reaching behind him to find his walker, trying to maintain his balance while he does so. His dining room chair also has wheels, and since moving in here he's learned to get in and out of it while it's pushed back against the dishwasher, so it doesn't roll out from under him. The old apartment had a carpeted dining area, so it wasn't an issue there.

While I'm over dropping off his coffee, it's a good time to refill his nebulizer. That second vial I left it there gets opened, along with the mouthpiece section, one fills the other, and that gets hung on its slot on the machine. I learned a couple months after he started using it, by finally reading the mylar packets the vials come in, that they can't be exposed to light for more than a week before becoming useless. Luckily I had never done that!

While he's finishing his breakfast, I'll go change into my work uniform. This is a good time to let the dog out again, always making sure when he comes back in that his favorite ball comes in with him. If not, he'll soon miss it, and wind up spending most of his time scratching at the door until somebody lets him out. Not my idea of the best way for Daddy to spend his morning.

Daddy will be in his living room chair listening to WCCO when I get back. It's time to pack the lunch cooler and water/ice jug, throw on my shoes, clean up any mess left from breakfast, make that last bathroom stop, and head out the door to work. On the way, I announce where I'm heading, ask if he needs anything more before I go. He'll ask if Meals on Wheels will be there at lunch time, and if any of his "girls" are coming that day. He's referring to the home health aids who visit him Monday, Wednesday, and Friday. It also used to refer to the physical therapist he had for a couple months. Tuesdays and alternate Thursdays (when Paul's not home to do it) it'll be Steve or Richard fixing his supper and setting out his evening pills, refilling his nebulizer for his bedtime dose, turning off his coffeemaker, and keeping him company for a bit. All the day's schedule will be imparted to him on my way, including any possible doctor's appointment, scheduled for Paul's days off so that he can drive his grandfather down. He also gets informed of who's still in the house.

Now, finally, I can head out to work.