It would be way less humiliating to simply claim being another victim of the re-freeze ice. After all, I'd be in great company. Jordan, for example, was jogging, slipped, and now wears a bandage on her face where a sharp bit of ice poked a hole through her cheek. She got up and immediately fell again, this time on her back.
I didn't see that damage.
While I do claim ice-damage occasionally when large numbers of explanations are requested, since it stops questions rather neatly, my inclination against lying brought me around to a simpler explanation that allows the asker to draw their own conclusions without piling too much humiliation on me, adding insult to injury, as it were. "I landed on it."
That is completely true, without adding the detail that I am seemingly capable of tripping on my own shadow. In actual fact, I tripped over a half step in my very own home, the entrance to my bedroom as one comes inside from the screen porch, where I had been chatting with Rich, exchanging details on Daddy before I left for work and he took over care.
My first reaction upon landing was a huge mental sigh of relief that this time, at least, I'd landed in a twisted position which avoided more tendon damage in my knees. I actually think I avoided bruising them this time. I merely needed to embark on the lengthy process of getting myself up off the floor and standing again, something involving contortions to avoid putting pressure on either kneecap. Richard tried to help, but I have evolved a method which doesn't involve anybody else putting their back out. It's not graceful or ladylike. It just works, slowly. Congratulating myself on having escaped damage, off I went to work.
OK, maybe there was a wee bit of bruising after all. There was a bit of soreness as the day progressed. No biggee.
Then about 2:00, I grabbed a thick envelope with about 5 lbs. of paper inside with my left hand, and that's when it hit. Boom!
I'd forgotten about the third point in my three-point-landing: my left hand. That took the brunt of the impact, being the first contact point. It seemed perfectly fine at the time. Turns out it was just a stalker, lying in wait. While I quickly transferred the package to my right hand, and began favoring the left, the damage was done. By 4:00 I informed dispatch I was done for the day. Since I was then in Shakopee, and there's rarely work there late in the day, there was no pressure for "just one more, it's going your way."
After sitting a bit, and upping the ibuprofin dose from my knee maintenance level of 2 pills to three, I started driving home, stopping in Stillwater to pick up Jordan for Saturday's auction. I also called Paul, home on his day off, for a piece of engineering for me. He'd need a paint stirring stick, in one 8" piece and one 3" piece, duct tape, padding (he cut up old socks), and an ace bandage. The wrist was going to need to be immobilized. We were designing a splint.
I actually did consider hitting an urgent care clinic to get it checked out - for about three minutes. Start with the $180 to walk in the door (last time I stopped), add in X-rays and the cost of a splint or cast, and, well... no. Whatever the diagnosis, the result was going to be immobilizing the wrist/hand. Let's cut to the chase and just immobilize the dang thing. And celebrate the wonderful US system that is for-profit healthcare and for-bigger-profit that US health insurance. It's the system that might actually cover the visit - if it exceeded the $3,000 deductible, and if I could afford to spend more than every after-tax dollar of my income on the monthly premiums for something that considers everything in my life a non-covered pre-existing condition anyway.
So no, do it myself. With a little help from my sons. OK, a lot of help.
I've had bruising, bone spurs, tendon damage, and joint damage from loss of cartilage. This doesn't feel like any of those. I think it's broken. I think it was a greenstick fracture until suddenly it wasn't any more, from the sudden stress of grabbing that heavy package just the wrong way. The pain pressure point is on the back of the hand, just above the wrist where the middle finger would extend down to through the hand. Don't push on it there. It hurts. I've tried it, so I can tell. There is a lump. There is no discoloration.
And there is an ache. Bending the wrist causes it, in whatever direction. Lifting fingers causes it. Grasping with fingers causes it. Stopping any of those things causes it, or at least allows it to continue. It reminds me not to use the hand. Or it tries. Problem is, I'm so thoroughly left-handed that I need it for everything. Except driving.
Back when I had my rotator cuff injury, from which I'm somewhat recovered now, to the point I can (could) use both arms equally to shampoo my hair, I had limited arm motion but still had full hand use. If I could get the hand to someplace, even if I needed to hold it in place with the right arm, I could still use it. I had full grip strength.
No more.
I've been finding out that it takes two hands to open a bottle, whether of water or pills. I can try to cradle it inside the elbow against my body, but it doesn't work well. I have limited finger use, something very apparent when pulling my pants on or off. I have discovered an itch that the right hand can't reach, and now the left can't either.
Yesterday I got an inkling of what work is going to be like. I had already learned to close the car door by reaching across with the right hand, but now I also have to have the seatbelt across my lap first. I can't begin to reach that with the right hand. Driving itself is no problem. I usually drive with one hand. (Shhhhh!) But the other things - turn signals, radio, holding the cell phone while talking, holding a glass of water or a bite of food, take more planning and don't come without pain. I expect there will be a lot more pulling over and stopping. Without any grip strength, there is no more than a token touch on the wheel if the right hand needs to do something else. Fortunately, my car doesn't pull to either side at the moment.
We use little Nextel phones to send text communications for dispatching. Think lots of button pushing. Think an extravagantly large and unnecessary number of buttons to push. Typing in the letter "s" involves 5 punches after however many to navigate to the right place to type it in to. Add six or seven more to delete and start over because the system just can't keep up with anything resembling speed and fails to recognize anything but the absolutely perfect level of pressure and a certain speed on the number pad. Now, I can barely hold my cell phone in the left hand just to talk. Any communication from dispatch means stopping the car. Any!
My real wake-up call came at the gas station yesterday. I had to sign the charge slip. It was the first thing I'd had to write since putting the splint on. I could barely hold the pen, much less apply pressure, and the splint (now corrected) held my hand so the pen was two inches higher than the paper. I put the receipt on top of my pocketbook, but it wasn't high enough or firm enough for a mark to register. The store clerk finally grabbed a carton of cigarettes to set on top of my pocketbook, and that worked, so long as I kept sliding the receipt so the place I was writing on was right next to the edge.
I returned the cigarettes, of course.
Even more fun was filling out the check after the auction, since I bought something for slightly more than my day's pay. The information was printed, not script, one slow wobbly letter at a time, and the signature was unrecognizable. It took about four minutes. (At least I can type on the keyboard with just the right hand, so I was still able to earn that day's pay.)
Tomorrow I have to fill in my tripsheet by hand, with name and address of every stop, and expect to have to fill in security logs at certain stops. All this doesn't even take into consideration picking up and carrying packages, or using handrails to navigate stairs with my lovely knees.
At this point the pain level increases with each use of the left hand, even with the splint. Tomorrow is going to be interesting. Oh yeah, there'll be new snow again, too.
Showing posts with label health. Show all posts
Showing posts with label health. Show all posts
Sunday, February 20, 2011
Sunday, December 5, 2010
Bracelets
The first one is white, with a wide space for a typed paper insert, giving his name, address, birthdate, and other information the hospital deems important.
The second is orange, marked in large letters "No Known Allergies".
The third is yellow, warning that falls can be an issue.
The fourth one is purple. It simply says DNR. This one was a long time in coming. Even yesterday he was telling the doctor that he wanted all possible measures taken to revive him should his heart fail. The doctor gave me two reasons that was not a good idea for him. First, should his heart fail, he could be deprived of oxygen long enough to cause serious brain damage. Second, any chest compressions would most likely break his ribs at his age. Thus any remaining time gained by CPR would be spent in pain.
We want to keep him as comfortable as possible. That's why he's likely coming home tomorrow. We'll know for sure after the lung specialist examines him again tomorrow. He'll be more comfortable at home. It won't make any difference to his pneumonia, which they have determined to be chronic rather than acute. That's why no fever, no real progress. Still, he'll likely get sent home with antibiotics just in case they can do some good. Being home won't help the fibrosis, or the emphysema, or the infiltrates found on his recent CT scan. And being home won't help his congestive heart failure any more than staying in the hospital would.
Nothing can.
But he can feel better here, more cared for, more comfortable.
He understands he will not be getting better than he is right now. He discussed his funeral, wanting to make sure he'd be cremated, his ashes buried alongside Mom's at Fort Snelling. I said, "Of course." Mom's urn has been waiting in my living room for 20 months now. He doesn't want us to be devastated when he goes, and joked that I didn't need to agree quite so quickly. His sense of humor is still there, along with his gratitude and appreciation.
He wants more help, so he can do less work, need to struggle to breathe less often. I'll be looking into what kinds of things can be done here at home, what kinds of assistance is available and who'll be paying for it. Tomorrow I'll have to ask at the hospital if they believe he qualifies for home hospice care. That would open some doors.
I think we'll leave the purple bracelet on.
The second is orange, marked in large letters "No Known Allergies".
The third is yellow, warning that falls can be an issue.
The fourth one is purple. It simply says DNR. This one was a long time in coming. Even yesterday he was telling the doctor that he wanted all possible measures taken to revive him should his heart fail. The doctor gave me two reasons that was not a good idea for him. First, should his heart fail, he could be deprived of oxygen long enough to cause serious brain damage. Second, any chest compressions would most likely break his ribs at his age. Thus any remaining time gained by CPR would be spent in pain.
We want to keep him as comfortable as possible. That's why he's likely coming home tomorrow. We'll know for sure after the lung specialist examines him again tomorrow. He'll be more comfortable at home. It won't make any difference to his pneumonia, which they have determined to be chronic rather than acute. That's why no fever, no real progress. Still, he'll likely get sent home with antibiotics just in case they can do some good. Being home won't help the fibrosis, or the emphysema, or the infiltrates found on his recent CT scan. And being home won't help his congestive heart failure any more than staying in the hospital would.
Nothing can.
But he can feel better here, more cared for, more comfortable.
He understands he will not be getting better than he is right now. He discussed his funeral, wanting to make sure he'd be cremated, his ashes buried alongside Mom's at Fort Snelling. I said, "Of course." Mom's urn has been waiting in my living room for 20 months now. He doesn't want us to be devastated when he goes, and joked that I didn't need to agree quite so quickly. His sense of humor is still there, along with his gratitude and appreciation.
He wants more help, so he can do less work, need to struggle to breathe less often. I'll be looking into what kinds of things can be done here at home, what kinds of assistance is available and who'll be paying for it. Tomorrow I'll have to ask at the hospital if they believe he qualifies for home hospice care. That would open some doors.
I think we'll leave the purple bracelet on.
Sunday, November 28, 2010
Homecoming
The voice on the voicemail informed me that Daddy had been discharged, and was reminding me he needed a ride home.
Duh!
I had already told him to expect me after lunch, meaning 1:00, and that's when I showed up, with Richard in tow carrying the home portable can of O2. I brought the bag of shirts, a diaper, and his winter jacket. For some strange reason they'd sent Paul home with those items when he was admitted a week earlier, but had kept his pants, socks and shoes. I still don't get that. But anyway, here we were with what he'd need.
As we passed by the nurses' station on our way to the room, I announced we were here to spring him, and suddenly we were the center of attention. "Oh dear, oh no, we're not sure he can go home yet."
OK, he's been discharged but can't go home? Seems he started feeling less well, and the doctor wanted to see him again before he left.
Fine, let's talk to her.
Well, she's gone to lunch, but she'll be back "soon."
Define "soon."
After she eats lunch.
We file into his room, set stuff down, find chairs. He's sitting in the large stuffed chair where they can lock the wheels so he doesn't fall when it rolls away from under him as he sits or stands. That seems to be its only good point. It's too deep to sit in comfortably, so it needs a pillow between chair back and patient back. It's too wide, so his elbows fall off the arm rests, particularly when he falls asleep, like he's doing now. It wakes him up, long enough to say "Hi," and get out about a sentence before he falls right back asleep again, mid-word. We get to watch that cycle through over and over for about an hour before he really wakes up. He's so sleep-deprived from being in the hospital that he can't stay awake, going in and out of REM sleep so fast one can hardly keep up. Needless to say, when he is "awake" he's unable to sort reality from dreams and says some pretty bizarre things.
I'm hoping it won't last when he gets home. It will be a humungous challenge to care for him when he's mostly not grounded in reality. I'm hoping a "real bed" and some real sleep will induce a better grip on reality.
Meanwhile staff come and go. We hear his nurse will come in and explain what's going on to us. We hear we're waiting for the doctor. We hear she's back from lunch and they'll flag her down as soon as feasible. We hear she's not back on the floor yet. The physical therapist comes in and puts him through some exercises. A nurse removes his catheter, and another later tries to assist him in self-cathing, with little luck. These are curved catheters and not the straight ones he uses at home, so I wonder if that's making a difference. Standing doesn't do it, so they have him lie down. There's a bit of success, but he's feeling like he still needs to go. He also feels the need for a bowel movement, even through there are new fresh brown spots on his bedding and his pressure-leggings and nobody has gotten around to changing anything yet. Obviously he's already had a rather sudden movement.
We call home to let them know what we don't know, especially when we might be home. The turkey has been put in the oven, since I promised him turkey dinner this evening after he missed the big family Thanksgiving. The clock rolls around, he wakes completely, finally, and asks to be put back in his bed so he can rest. The clock keeps rolling around.
Finally, a doctor shows up, the husband of the doctor we've been waiting for to finish what must be a very long lunch. He asks Daddy a few questions about going home, and he's given all the "right" answers. Daddy is right now determined to leave. He insists that his not feeling well earlier was all in his head, being afraid of leaving his vast support system of the hospital. Now he's fine.
OK, then, he can go home.
Now it's another parade through the room. One nurse gives us a stack of papers to read, and tells us to ask any questions. Let's start with one page saying give him no aspirin, and another says continue the baby aspirin daily. He's due a last antibiotic today, 2:00 PM, which had now passed, and why can't he get that at the hospital before he leaves? After a check of his chart, it's decided that somebody got the date wrong, the pill is due tomorrow, so we still have to run over to his pharmacy, 26 miles in the other direction, and pick that up. But it won't be a wasted trip, because now he need iron supplements, and.... But, hey, tomorrow's fine.
Yeah, well, tomorrow's busy, because the dog has to go to the vet, so we'll be shuffling schedules around so somebody's there while I'm gone, and he gets lunch at the right time, and....
Then there's the IV needle that needs to get removed from his arm before he can go, and getting him dressed, and getting out the door for real, into the now icy-cold car, and home, and into the house and down in his favorite chair, all just in time to be served turkey dinner, dressing, cranberry salad, au gratins, and juice.
Whew!
He's so tired he goes to bed just after 7:00. Normal bedtime has been between 8:00 and 10:00, usually hitting 9:00. Of course, he makes up for it by getting up before 5:00, so guess who gets very little sleep, since I'm not ready to go to sleep before my usual time. And now he's very uncomfortable, since the plumbing isn't working. Add to that, he can't remember after a week away where everything is the house is. At 5:00 he's already been trying to figure out where in his O2 tubing is the button to push for the nurse. He finally yells, and the baby monitor, finally plugged in again after disconnecting for my brother's visit, wakes me up. (Yes, Steve, I did disconnect it. I don't need to know if you snore. Really!)
But his plumbing is the big worry. According to him, the first self-cath produces 4 drops. This is after asking me where they are when he's standing next to them in their usual space. The next yields 6. Two more produce a bit of very temporary relief, but not really emptying the bladder. His belly is taut, usually sign of constipation and/or gas. We wonder if he needs to go back to urgent care and get a foley and bag put back in, if that part was discontinued too soon.
But I have to take the dog to the vet. His distemper shot is due, and being a cocker spaniel, he has another ear infection. During his exam, I spy a brown mouse scurrying under the door into the next room and mention it to the vet. She freaks out, which I find a tad odd. After all, it's just a mouse. Sure, they eat food and might carry diseases, and probably aren't good for the business's PR, but it's still just a mouse.
They know there's a mouse problem. She hates those sticky traps, won't use poisons in case the clients get into them, or the mice do and stink in the walls while they decompose, and have been using a little tunnel kind of trap that electrocutes the mice as they walk through. It's an interesting diversion, but I need to get this visit over and get back to Daddy and see what can/must be done. The dog goes home with an antibiotic that gets squirted deep in his ear canals after they get cleaned, twice a day. It's mixed with something that makes it get sucked right through the skin, so whoever's treating him needs to wear gloves. Luckily, with Daddy, we have a nearly full box of them at the moment.
As I walk in the house, Daddy informs me the nurse has called, knows about his "peeing problem", and is coming right over.
Huh? What nurse? Who called her? Why is somebody sending her over? Hospitals don't do that. It's Saturday. Is this just another of those unreality post-dream confusions? I must confess to sounding a little skeptical and patronizing at the same time as I tried to make sense of what he was saying. He insisted it wasn't a dream, and, much as he needed to pee, was waiting for her to show up first. After a half hour, I insisted he go try now since he was so uncomfortable.
While he was in the bathroom, sure enough, a car pulls in the driveway and a woman gets out, toting a large multi-chambered black case up the driveway. Oh Halleluia, it's Randy!
Randy is the county health nurse, in charge of his home health aids. I had left her a message that he was to be discharged, so that the aids would know to start in again on Monday. Now here she was, checking out his health, his new meds, his capabilities and needs, and setting up Medicare to take over payments for whatever they would cover post-hospitalization so for a bit he doesn't have to pay himself. Again. Randy is the one who visits when we get anxious about his care, who has tips for getting done what needs to be accomplished, and helps me to keep thinking I can keep doing this.
In all the visit lasted well over an hour, and ended with her supervising him self-cathing to see what was really going on. Her conclusion was that he was peeing a lot more than he thought, not being able to see or hear the stream. She also added a bunch of stuff to the shopping list - since I hadn't gotten out of the house yet to do it. Mostly it was stuff to keep his bowels moving, to relieve that pressure. She also reassured him that his feeling sick after leaving the hospital was typical, since these days they release patients earlier and expect them to recover at home, decreasing health care costs to the insurance companies. He should expect a slow recovery, but he should expect recovery.
I think we both felt better after her visit. Last night and most of today he's perked up a bit, although the slow improvement in breathing has him discouraged. Tonight, after a pretty good day including watching the Vikings win against Washington, he insisted on going to bed for the night at 4:00. He could not be persuaded that he could take a nap, have supper, and then go to bed. He finally let me talk him into having his medications and some juice first. But absolutely no supper!
After all, he might not live that long!
Alllllrighty then. I just finished putting him to bed, telling him if he didn't last the night, we'd deal with it in the morning. I'm just afraid for him it means morning is going to come about 3:30 AM! That means for me too. He'll want to get up and dressed, have coffee, and sit in his chair in the living room and listen to his radio.
I get to go back to work tomorrow. I'd just like some sleep first.
Duh!
I had already told him to expect me after lunch, meaning 1:00, and that's when I showed up, with Richard in tow carrying the home portable can of O2. I brought the bag of shirts, a diaper, and his winter jacket. For some strange reason they'd sent Paul home with those items when he was admitted a week earlier, but had kept his pants, socks and shoes. I still don't get that. But anyway, here we were with what he'd need.
As we passed by the nurses' station on our way to the room, I announced we were here to spring him, and suddenly we were the center of attention. "Oh dear, oh no, we're not sure he can go home yet."
OK, he's been discharged but can't go home? Seems he started feeling less well, and the doctor wanted to see him again before he left.
Fine, let's talk to her.
Well, she's gone to lunch, but she'll be back "soon."
Define "soon."
After she eats lunch.
We file into his room, set stuff down, find chairs. He's sitting in the large stuffed chair where they can lock the wheels so he doesn't fall when it rolls away from under him as he sits or stands. That seems to be its only good point. It's too deep to sit in comfortably, so it needs a pillow between chair back and patient back. It's too wide, so his elbows fall off the arm rests, particularly when he falls asleep, like he's doing now. It wakes him up, long enough to say "Hi," and get out about a sentence before he falls right back asleep again, mid-word. We get to watch that cycle through over and over for about an hour before he really wakes up. He's so sleep-deprived from being in the hospital that he can't stay awake, going in and out of REM sleep so fast one can hardly keep up. Needless to say, when he is "awake" he's unable to sort reality from dreams and says some pretty bizarre things.
I'm hoping it won't last when he gets home. It will be a humungous challenge to care for him when he's mostly not grounded in reality. I'm hoping a "real bed" and some real sleep will induce a better grip on reality.
Meanwhile staff come and go. We hear his nurse will come in and explain what's going on to us. We hear we're waiting for the doctor. We hear she's back from lunch and they'll flag her down as soon as feasible. We hear she's not back on the floor yet. The physical therapist comes in and puts him through some exercises. A nurse removes his catheter, and another later tries to assist him in self-cathing, with little luck. These are curved catheters and not the straight ones he uses at home, so I wonder if that's making a difference. Standing doesn't do it, so they have him lie down. There's a bit of success, but he's feeling like he still needs to go. He also feels the need for a bowel movement, even through there are new fresh brown spots on his bedding and his pressure-leggings and nobody has gotten around to changing anything yet. Obviously he's already had a rather sudden movement.
We call home to let them know what we don't know, especially when we might be home. The turkey has been put in the oven, since I promised him turkey dinner this evening after he missed the big family Thanksgiving. The clock rolls around, he wakes completely, finally, and asks to be put back in his bed so he can rest. The clock keeps rolling around.
Finally, a doctor shows up, the husband of the doctor we've been waiting for to finish what must be a very long lunch. He asks Daddy a few questions about going home, and he's given all the "right" answers. Daddy is right now determined to leave. He insists that his not feeling well earlier was all in his head, being afraid of leaving his vast support system of the hospital. Now he's fine.
OK, then, he can go home.
Now it's another parade through the room. One nurse gives us a stack of papers to read, and tells us to ask any questions. Let's start with one page saying give him no aspirin, and another says continue the baby aspirin daily. He's due a last antibiotic today, 2:00 PM, which had now passed, and why can't he get that at the hospital before he leaves? After a check of his chart, it's decided that somebody got the date wrong, the pill is due tomorrow, so we still have to run over to his pharmacy, 26 miles in the other direction, and pick that up. But it won't be a wasted trip, because now he need iron supplements, and.... But, hey, tomorrow's fine.
Yeah, well, tomorrow's busy, because the dog has to go to the vet, so we'll be shuffling schedules around so somebody's there while I'm gone, and he gets lunch at the right time, and....
Then there's the IV needle that needs to get removed from his arm before he can go, and getting him dressed, and getting out the door for real, into the now icy-cold car, and home, and into the house and down in his favorite chair, all just in time to be served turkey dinner, dressing, cranberry salad, au gratins, and juice.
Whew!
He's so tired he goes to bed just after 7:00. Normal bedtime has been between 8:00 and 10:00, usually hitting 9:00. Of course, he makes up for it by getting up before 5:00, so guess who gets very little sleep, since I'm not ready to go to sleep before my usual time. And now he's very uncomfortable, since the plumbing isn't working. Add to that, he can't remember after a week away where everything is the house is. At 5:00 he's already been trying to figure out where in his O2 tubing is the button to push for the nurse. He finally yells, and the baby monitor, finally plugged in again after disconnecting for my brother's visit, wakes me up. (Yes, Steve, I did disconnect it. I don't need to know if you snore. Really!)
But his plumbing is the big worry. According to him, the first self-cath produces 4 drops. This is after asking me where they are when he's standing next to them in their usual space. The next yields 6. Two more produce a bit of very temporary relief, but not really emptying the bladder. His belly is taut, usually sign of constipation and/or gas. We wonder if he needs to go back to urgent care and get a foley and bag put back in, if that part was discontinued too soon.
But I have to take the dog to the vet. His distemper shot is due, and being a cocker spaniel, he has another ear infection. During his exam, I spy a brown mouse scurrying under the door into the next room and mention it to the vet. She freaks out, which I find a tad odd. After all, it's just a mouse. Sure, they eat food and might carry diseases, and probably aren't good for the business's PR, but it's still just a mouse.
They know there's a mouse problem. She hates those sticky traps, won't use poisons in case the clients get into them, or the mice do and stink in the walls while they decompose, and have been using a little tunnel kind of trap that electrocutes the mice as they walk through. It's an interesting diversion, but I need to get this visit over and get back to Daddy and see what can/must be done. The dog goes home with an antibiotic that gets squirted deep in his ear canals after they get cleaned, twice a day. It's mixed with something that makes it get sucked right through the skin, so whoever's treating him needs to wear gloves. Luckily, with Daddy, we have a nearly full box of them at the moment.
As I walk in the house, Daddy informs me the nurse has called, knows about his "peeing problem", and is coming right over.
Huh? What nurse? Who called her? Why is somebody sending her over? Hospitals don't do that. It's Saturday. Is this just another of those unreality post-dream confusions? I must confess to sounding a little skeptical and patronizing at the same time as I tried to make sense of what he was saying. He insisted it wasn't a dream, and, much as he needed to pee, was waiting for her to show up first. After a half hour, I insisted he go try now since he was so uncomfortable.
While he was in the bathroom, sure enough, a car pulls in the driveway and a woman gets out, toting a large multi-chambered black case up the driveway. Oh Halleluia, it's Randy!
Randy is the county health nurse, in charge of his home health aids. I had left her a message that he was to be discharged, so that the aids would know to start in again on Monday. Now here she was, checking out his health, his new meds, his capabilities and needs, and setting up Medicare to take over payments for whatever they would cover post-hospitalization so for a bit he doesn't have to pay himself. Again. Randy is the one who visits when we get anxious about his care, who has tips for getting done what needs to be accomplished, and helps me to keep thinking I can keep doing this.
In all the visit lasted well over an hour, and ended with her supervising him self-cathing to see what was really going on. Her conclusion was that he was peeing a lot more than he thought, not being able to see or hear the stream. She also added a bunch of stuff to the shopping list - since I hadn't gotten out of the house yet to do it. Mostly it was stuff to keep his bowels moving, to relieve that pressure. She also reassured him that his feeling sick after leaving the hospital was typical, since these days they release patients earlier and expect them to recover at home, decreasing health care costs to the insurance companies. He should expect a slow recovery, but he should expect recovery.
I think we both felt better after her visit. Last night and most of today he's perked up a bit, although the slow improvement in breathing has him discouraged. Tonight, after a pretty good day including watching the Vikings win against Washington, he insisted on going to bed for the night at 4:00. He could not be persuaded that he could take a nap, have supper, and then go to bed. He finally let me talk him into having his medications and some juice first. But absolutely no supper!
After all, he might not live that long!
Alllllrighty then. I just finished putting him to bed, telling him if he didn't last the night, we'd deal with it in the morning. I'm just afraid for him it means morning is going to come about 3:30 AM! That means for me too. He'll want to get up and dressed, have coffee, and sit in his chair in the living room and listen to his radio.
I get to go back to work tomorrow. I'd just like some sleep first.
Thursday, November 25, 2010
Finally, Good News!
I'm beginning to think that IV antibiotics can beat the bug even when the immune system is barely functioning. Levaquin must be pretty powerful stuff. Let's just hope it doesn't get overused like all the other antibiotics so it quits working when the critters adapt to it. I've grown up with antibiotics. I like the thought of them continuing to be a presence I can count on when needed.
But enough about that. Daddy's coming home tomorrow!!!!
I got a call from his doctor Tuesday, just after my brother and his wife left to go back to Bemidji and try to cope with 12 inches of new snow they'd just gotten, with the plow driver on vacation and no backup driver for their township road, and with another anticipated 6-8" on the way starting yesterday. They traveled between storms.
His hospital doctor said he was getting well enough to come home Friday, and she was starting physical therapy for him that day, ordering more for after he got home. The Foley had already been removed, and the IV pole was not visible when I'd stopped by that morning before work. (Later in the day I saw it tucked behind the curtain, so they were still giving antibiotics.) When the nurse had been in to check lung noises, she commented she was hearing them on one side but the other side was quiet. I think that meant he was rattling only on one side now, rather than he was breathing on only one side now. Anyway, she made it sound like good news.
He's quit talking about dying, and started talking about the pleasures of coming home. Like having bacon. It's been part of his breakfast for years, but the hospital has him on a cardiac diet and won't permit it. I told him to think of it as a reason to get up and walking when he didn't really feel like it so he could get strong enough to have his bacon again. After all, at 96 and 1/2, his home diet is whatever he wants to eat. Meals on Wheels has him on low salt, but that's as restrictive as it gets. I figure he's not eating to try to live another 50 years, so he may as well enjoy what time he has. Food is one of his few remaining pleasures. He's already had his tripple bypass in the 70's and his pacemaker is good for another year before they will want to replace it. So we introduce him to foreign cuisines which Mom never did, leave cookies out to munch on, and generally try to make food interesting.
He's also talking about listening to his radio again. We discussed finding out whether the Vikings are playing this weekend, so he can sit in his chair a foot from the TV screen to make out what he can of the game until he gets so disgusted with their bad playing that he has us turn it off. Since he can't read, and hasn't the attention span/memory to listen to books on tape anymore, WCCO is what keeps him company through the day while we're at work. Or even while we're home.
Speaking of, we've arranged to have somebody in the house with him 24/7 for the next ten days, partly keeping him company, partly making sure he's walking on his own, and safely.
It's time now to bake a couple pies, clean up, give my fiancee a haircut, rearrange the car for passengers, head to the hospital for a visit, then come back and get ready for the big family Thanksgiving this afternoon/evening. I even get to pick up my granddaughter on the way for a change. Apparently her mom's extended family won't be celebrating on the day itself. Not that she's said that exactly, but it's what I take it she means when she say's she's available to join us this year. (Considering some things that get said in that family, and the fact that she's not living at home, perhaps she's just more comfortable not joining them?) I have to remember to pack my son-in-law's boots which he left at my brother's when he went up deer hunting ( at least he remembered to pack back his deer), my granddaughter's earrings she left on her last visit, pie, turkey stuffing, bread and jelly, the curried broccoli, and the catawba juice, which are our family's contributions to the pot luck feast and general merriment.
Let's see, there's got to be a post-it for a list somewhere....
Oh, and for those who've been paying attention to such things, Rich will be joining us. The judge didn't want to keep him over the holiday. He got picked up and transported all the way to the Dakota County jail for non-payment of child support on Tuesday morning, and I got to add picking him up to my to-do list for yesterday during the snowstorm. Luckily a job popped that took me to the same building, so it wasn't cutting into my work schedule. But he has to go back before the judge in a couple weeks, and that will.
But enough about that. Daddy's coming home tomorrow!!!!
I got a call from his doctor Tuesday, just after my brother and his wife left to go back to Bemidji and try to cope with 12 inches of new snow they'd just gotten, with the plow driver on vacation and no backup driver for their township road, and with another anticipated 6-8" on the way starting yesterday. They traveled between storms.
His hospital doctor said he was getting well enough to come home Friday, and she was starting physical therapy for him that day, ordering more for after he got home. The Foley had already been removed, and the IV pole was not visible when I'd stopped by that morning before work. (Later in the day I saw it tucked behind the curtain, so they were still giving antibiotics.) When the nurse had been in to check lung noises, she commented she was hearing them on one side but the other side was quiet. I think that meant he was rattling only on one side now, rather than he was breathing on only one side now. Anyway, she made it sound like good news.
He's quit talking about dying, and started talking about the pleasures of coming home. Like having bacon. It's been part of his breakfast for years, but the hospital has him on a cardiac diet and won't permit it. I told him to think of it as a reason to get up and walking when he didn't really feel like it so he could get strong enough to have his bacon again. After all, at 96 and 1/2, his home diet is whatever he wants to eat. Meals on Wheels has him on low salt, but that's as restrictive as it gets. I figure he's not eating to try to live another 50 years, so he may as well enjoy what time he has. Food is one of his few remaining pleasures. He's already had his tripple bypass in the 70's and his pacemaker is good for another year before they will want to replace it. So we introduce him to foreign cuisines which Mom never did, leave cookies out to munch on, and generally try to make food interesting.
He's also talking about listening to his radio again. We discussed finding out whether the Vikings are playing this weekend, so he can sit in his chair a foot from the TV screen to make out what he can of the game until he gets so disgusted with their bad playing that he has us turn it off. Since he can't read, and hasn't the attention span/memory to listen to books on tape anymore, WCCO is what keeps him company through the day while we're at work. Or even while we're home.
Speaking of, we've arranged to have somebody in the house with him 24/7 for the next ten days, partly keeping him company, partly making sure he's walking on his own, and safely.
It's time now to bake a couple pies, clean up, give my fiancee a haircut, rearrange the car for passengers, head to the hospital for a visit, then come back and get ready for the big family Thanksgiving this afternoon/evening. I even get to pick up my granddaughter on the way for a change. Apparently her mom's extended family won't be celebrating on the day itself. Not that she's said that exactly, but it's what I take it she means when she say's she's available to join us this year. (Considering some things that get said in that family, and the fact that she's not living at home, perhaps she's just more comfortable not joining them?) I have to remember to pack my son-in-law's boots which he left at my brother's when he went up deer hunting ( at least he remembered to pack back his deer), my granddaughter's earrings she left on her last visit, pie, turkey stuffing, bread and jelly, the curried broccoli, and the catawba juice, which are our family's contributions to the pot luck feast and general merriment.
Let's see, there's got to be a post-it for a list somewhere....
Oh, and for those who've been paying attention to such things, Rich will be joining us. The judge didn't want to keep him over the holiday. He got picked up and transported all the way to the Dakota County jail for non-payment of child support on Tuesday morning, and I got to add picking him up to my to-do list for yesterday during the snowstorm. Luckily a job popped that took me to the same building, so it wasn't cutting into my work schedule. But he has to go back before the judge in a couple weeks, and that will.
Sunday, November 21, 2010
No Fever
I was brought up to think that was a good thing. It meant you weren't sick. Turns out it can mean you simply aren't fighting what's making you sick. If you live long enough, your body can quit making white cells, the ones that fight infections. That is definitely not a good thing. And this is what they think is happening with my dad.
His doctor for the day called from the hospital. His pneumonia is worse. His nurse says he is getting weaker, but they're going to get him walking, provided he can suck in enough O2 to make it work. Taken together it means they haven't given up hope. Or they're going through the motions. The outlook is not good, but the doctor was unwilling to commit to pessimism. Everything I was hearing said it's time for the family to make those last visits, but she specifically wouldn't say that.
I asked.
Perhaps she's young and that's hard for her. Perhaps she knows something she's not saying. Perhaps she's scared - of death? of our reactions? of her own failure to cure every time? Who knows?
But tomorrow my brother and his wife are driving down, and staying overnight. They'll head back home before the next expected winter storm blows through on Wednesday.
They'll get to see his cool room with a couch (bed?), microwave, and 'fridge in it. It seems made for family to stay with a patient. The staff even offer free supper for family along with the patient's meal. The nurses are all very attentive, helpful, and make frequent visits to his room. I asked if he could have a radio brought in so he could listen to WCCO, since the TV is not useful. She found two. The first had no antenna and emitted only a hum. The second had an antenna but still emitted only a hum. Today there was no radio sitting by his bed even pretending to be of use. It freed up table-top space for all the other things that could be of use.
They have special coverings on his calves that alternately blow up and deflate to improve circulation, but his feet are still cold, even with all the extra blankets. There's a dry-erase board by his bed with the day, date, and names of his nurse and his other assigned assistant, whatever the jargon is that they use. Not that he can read it, but family can, so we know whom to ask questions of. Once I brought it to their attention this afternoon, the date got corrected for the first time since he was admitted. Not that he noticed, but they were consistently a day behind. How do you keep changing it and getting it wrong? Are they just so programmed to add one that they don't stop to think?
Tomorrow I'll be back at work, but unless it's icy again like this morning, I'll stop in to visit him first, and then again after work. The ice didn't melt until after two, so I delayed my visit this afternoon. Going down an icy steep hill into Taylors Falls and back up into St. Croix Falls is not my ideal way to arrive at the hospital, but likely as effective. Going home again might easily be delayed, however. They might put us in adjoining rooms, though.
For now, it's just one day at a time, seeing how things go. Planning for his return. Planning for not. And just hanging in there.
His doctor for the day called from the hospital. His pneumonia is worse. His nurse says he is getting weaker, but they're going to get him walking, provided he can suck in enough O2 to make it work. Taken together it means they haven't given up hope. Or they're going through the motions. The outlook is not good, but the doctor was unwilling to commit to pessimism. Everything I was hearing said it's time for the family to make those last visits, but she specifically wouldn't say that.
I asked.
Perhaps she's young and that's hard for her. Perhaps she knows something she's not saying. Perhaps she's scared - of death? of our reactions? of her own failure to cure every time? Who knows?
But tomorrow my brother and his wife are driving down, and staying overnight. They'll head back home before the next expected winter storm blows through on Wednesday.
They'll get to see his cool room with a couch (bed?), microwave, and 'fridge in it. It seems made for family to stay with a patient. The staff even offer free supper for family along with the patient's meal. The nurses are all very attentive, helpful, and make frequent visits to his room. I asked if he could have a radio brought in so he could listen to WCCO, since the TV is not useful. She found two. The first had no antenna and emitted only a hum. The second had an antenna but still emitted only a hum. Today there was no radio sitting by his bed even pretending to be of use. It freed up table-top space for all the other things that could be of use.
They have special coverings on his calves that alternately blow up and deflate to improve circulation, but his feet are still cold, even with all the extra blankets. There's a dry-erase board by his bed with the day, date, and names of his nurse and his other assigned assistant, whatever the jargon is that they use. Not that he can read it, but family can, so we know whom to ask questions of. Once I brought it to their attention this afternoon, the date got corrected for the first time since he was admitted. Not that he noticed, but they were consistently a day behind. How do you keep changing it and getting it wrong? Are they just so programmed to add one that they don't stop to think?
Tomorrow I'll be back at work, but unless it's icy again like this morning, I'll stop in to visit him first, and then again after work. The ice didn't melt until after two, so I delayed my visit this afternoon. Going down an icy steep hill into Taylors Falls and back up into St. Croix Falls is not my ideal way to arrive at the hospital, but likely as effective. Going home again might easily be delayed, however. They might put us in adjoining rooms, though.
For now, it's just one day at a time, seeing how things go. Planning for his return. Planning for not. And just hanging in there.
Saturday, November 20, 2010
But, But, Pineapple Juice?
Randy is great, and our conversations are always fun, despite the serious reasons for them. She's the county public health nurse, supervisor to the home health aids that come in and take care of my dad. When there's a change, or a problem, we talk. Whatever needs to, gets done.
My dad's cold had long since appeared to disappear. No runny nose, very little coughing, the "I'm sick" feeling long gone. Only problem is, he got out-of-breath just in the process of sitting up in bed in the morning. Even with the help of a pulling hand. And on oxygen. So I called Randy and asked her if she could come out and help me assess his condition, see if he needed medical intervention. She has lots of little tools that can do things like measure his blood oxygen saturation, listen to his lungs. Add to that the experience to know what she's dealing with, and the willingness to make house calls, and we're set.
She checked her schedule and made room to come out the next morning, but first, she gave me a shopping list. We needed my dad to be able to cough up whatever was clogging his lungs. She figured the stuff was just sticking to the sides. Then she could diagnose from color - icky yellow or green - whether there was an infection that needed medicating. Problem was, he coughed little and usually came up dry. She had a solution for that. Three, actually.
First, Robitussin. No fancy add-ons, just plain Guaifenesin, the expectorant. Generic would be fine. And watch the dosage because they've been diluting it these days so you need to take more than you used to have to: read the label. Why? I envisioned some kid getting into it, and saying, "Gee, Daddy, I didn't kill myself on all the medicine because I got full on all the water first!"
Then Vicks Vapo-Rub. Now that's a name from the past. My last memory of that is Mom using it on my chest and me fighting with her because it tickled so. Needless to say, I had no idea what it looked like or where to find it in the store, but lucked into finding a stocking person in the department when I needed one. Randy added that I needed to not only rub it on his chest, but into the bottoms of his feet as well, especially the ball of each foot.
Huh? Really?
She explained it worked like reflexology, and the ball of the foot was connected to the lungs. Treat it, treat them.
OK, yeah, whatever. No biggie to rub it in a couple extra spots, and he seemed to enjoy it. The idea tickled me, the reality didn't literally tickle him. So we're good. Oh, and she said to also use it to cure toenail fungus. Talk about off-label medications! But hey, maybe I'll try that some day. When I've got some time.
Now there was just one last thing I needed to pick up: pineapple! Either the fruit bits or the juice. Or both. Apparently one of its actions is to loosen up the crap in the lungs so it can be coughed out. Mother Nature's own special little cure was how Randy put it. For me, this would be extreme. I am not a pineapple fan. My dad, however, likes it. So I got both. Juice for bedtime and breakfast drink, and fruit for breakfast fruit cup.
With all the cures and nostrums liberally applied, he was coughing up crap as I left for work Friday. I told him to save it so Randy could see it, cough into a handkerchief rather than a tissue. Around 10:30 I got a call from her: he definitely had a respiratory tract infection. It was a nasty green. Moreover, his blood oxygen levels, at 97% resting, bottomed out when he walked to the bathroom even though he remained connected to his O2. And by the way, who turned the concentrator machine up to 3? It was set at 2.
Nobody claimed responsibility, though it seems to have been a good idea. Maybe a lucky bump when it got moved across the room.
But anyway, he needed to be seen. Oh, and by the way, he also seemed to have a galloping UTI at the same time.
Since it was Friday, I told her to walk down the hall and knock on Paul's door, wake him up, and explain what was needed. She did, and he did.
Around 3 I got another call, this time from Paul. The hospital, site of the urgent care clinic, had decided to admit him "overnight for observation." Plus, they were administering IV antibiotics. Yes, he had a UTI. He also had pneumonia, according to the X-rays.
By the time I stopped in after work, the nurses were trying to figure out how to keep his foot warm. This is the one that has nerve damage from the first hip replacement surgery, where they let the leg stretch and severed the nerve that allows him to lift the foot. Malpractice settlement, foot brace, handicap status officially. This last year or so, it's been getting cold to his senses, during cooler weather. We've been putting on double socks at night, then tripple on that foot, and adding blankets on the bed. Occasionally a very-warm foot-bath helps. We're thinking about trying an electric blanket. The problem is, the foot often isn't really cold, but the nerve damage tells him that it is. It keeps him from sleeping well. So his nurses were piling on the blankets, and I was offering advice. Finally he asked for a heavy-duty sleeping pill at bedtime in hopes that that would keep him asleep enough to stop noticing it.
His attitude is good, his breathing seems fine - at least while he's just lying in bed with his head elevated and getting hospital O2. Same little 2-prong tube in the nose, hooked around the ears. The IV treatment was done, though the ports were still taped on the back of his hand, and he was ignoring the fruit cup on the table by his bed. The Foley keeps him from needing to get up and about, and after a minor irrigation, the abdominal pain disappeared. Apparently he was a wee bit clogged.
I'm to call in after 10 this morning and find out how he's doing, whether he's staying longer or coming home. I could have even slept in this morning, with nobody to get out of bed, dressed, dosed, and fed. Unfortunately, my body knows its wakin' up time. I'll catch a nap later.
But, hey, really: pineapple juice?
My dad's cold had long since appeared to disappear. No runny nose, very little coughing, the "I'm sick" feeling long gone. Only problem is, he got out-of-breath just in the process of sitting up in bed in the morning. Even with the help of a pulling hand. And on oxygen. So I called Randy and asked her if she could come out and help me assess his condition, see if he needed medical intervention. She has lots of little tools that can do things like measure his blood oxygen saturation, listen to his lungs. Add to that the experience to know what she's dealing with, and the willingness to make house calls, and we're set.
She checked her schedule and made room to come out the next morning, but first, she gave me a shopping list. We needed my dad to be able to cough up whatever was clogging his lungs. She figured the stuff was just sticking to the sides. Then she could diagnose from color - icky yellow or green - whether there was an infection that needed medicating. Problem was, he coughed little and usually came up dry. She had a solution for that. Three, actually.
First, Robitussin. No fancy add-ons, just plain Guaifenesin, the expectorant. Generic would be fine. And watch the dosage because they've been diluting it these days so you need to take more than you used to have to: read the label. Why? I envisioned some kid getting into it, and saying, "Gee, Daddy, I didn't kill myself on all the medicine because I got full on all the water first!"
Then Vicks Vapo-Rub. Now that's a name from the past. My last memory of that is Mom using it on my chest and me fighting with her because it tickled so. Needless to say, I had no idea what it looked like or where to find it in the store, but lucked into finding a stocking person in the department when I needed one. Randy added that I needed to not only rub it on his chest, but into the bottoms of his feet as well, especially the ball of each foot.
Huh? Really?
She explained it worked like reflexology, and the ball of the foot was connected to the lungs. Treat it, treat them.
OK, yeah, whatever. No biggie to rub it in a couple extra spots, and he seemed to enjoy it. The idea tickled me, the reality didn't literally tickle him. So we're good. Oh, and she said to also use it to cure toenail fungus. Talk about off-label medications! But hey, maybe I'll try that some day. When I've got some time.
Now there was just one last thing I needed to pick up: pineapple! Either the fruit bits or the juice. Or both. Apparently one of its actions is to loosen up the crap in the lungs so it can be coughed out. Mother Nature's own special little cure was how Randy put it. For me, this would be extreme. I am not a pineapple fan. My dad, however, likes it. So I got both. Juice for bedtime and breakfast drink, and fruit for breakfast fruit cup.
With all the cures and nostrums liberally applied, he was coughing up crap as I left for work Friday. I told him to save it so Randy could see it, cough into a handkerchief rather than a tissue. Around 10:30 I got a call from her: he definitely had a respiratory tract infection. It was a nasty green. Moreover, his blood oxygen levels, at 97% resting, bottomed out when he walked to the bathroom even though he remained connected to his O2. And by the way, who turned the concentrator machine up to 3? It was set at 2.
Nobody claimed responsibility, though it seems to have been a good idea. Maybe a lucky bump when it got moved across the room.
But anyway, he needed to be seen. Oh, and by the way, he also seemed to have a galloping UTI at the same time.
Since it was Friday, I told her to walk down the hall and knock on Paul's door, wake him up, and explain what was needed. She did, and he did.
Around 3 I got another call, this time from Paul. The hospital, site of the urgent care clinic, had decided to admit him "overnight for observation." Plus, they were administering IV antibiotics. Yes, he had a UTI. He also had pneumonia, according to the X-rays.
By the time I stopped in after work, the nurses were trying to figure out how to keep his foot warm. This is the one that has nerve damage from the first hip replacement surgery, where they let the leg stretch and severed the nerve that allows him to lift the foot. Malpractice settlement, foot brace, handicap status officially. This last year or so, it's been getting cold to his senses, during cooler weather. We've been putting on double socks at night, then tripple on that foot, and adding blankets on the bed. Occasionally a very-warm foot-bath helps. We're thinking about trying an electric blanket. The problem is, the foot often isn't really cold, but the nerve damage tells him that it is. It keeps him from sleeping well. So his nurses were piling on the blankets, and I was offering advice. Finally he asked for a heavy-duty sleeping pill at bedtime in hopes that that would keep him asleep enough to stop noticing it.
His attitude is good, his breathing seems fine - at least while he's just lying in bed with his head elevated and getting hospital O2. Same little 2-prong tube in the nose, hooked around the ears. The IV treatment was done, though the ports were still taped on the back of his hand, and he was ignoring the fruit cup on the table by his bed. The Foley keeps him from needing to get up and about, and after a minor irrigation, the abdominal pain disappeared. Apparently he was a wee bit clogged.
I'm to call in after 10 this morning and find out how he's doing, whether he's staying longer or coming home. I could have even slept in this morning, with nobody to get out of bed, dressed, dosed, and fed. Unfortunately, my body knows its wakin' up time. I'll catch a nap later.
But, hey, really: pineapple juice?
Wednesday, October 27, 2010
Plan D? Plan E?
When my dad was first ordered oxygen for home use, the plan was to put the concentrator in the middle of his apartment and trail the tubing around, attached to him wherever he wandered. That lasted a couple days. His complaint was the inconvenience of the tubing, managing it while walking so it didn't become a tripping hazard. Luckily, he never actually tripped over it, but that danger was/is ever present in our minds.
Plan B was to keep the concentrator near his lift chair, the place he spends most of his time. A small amount of the 50 feet of tubing could be played out, giving him moderate mobility while staying connected, and the rest remaining coiled up in a box next to the machine. It didn't seem to want to stay coiled up, so eventually a section of it was loosely "knotted" around a convenient protrusion on the machine, with about 10 feet left to keep track of. He didn't need it while sleeping, and this served well enough, even after he moved in with the family up here.
Plan C was actually a lessening of use. A year on nebulizer meds yielded increasing lung capacity, until the county nurse (who regularly visits as part of our using county home health aids for his care) declared she heard breath sounds all through his lungs, a first for her. They agreed that he would use the oxygen only when he needed it, during those times of high activity.
The afternoon I returned home to hear him declare he didn't need it anymore (at all, to hear him say it) ended with a hasty set of phone calls to find out just what the heck the nurse thought she was doing! Hearing the full, rational explanation was quite helpful, and I got to (try to) pass the corrected information back on to him. Somehow the wrong information stuck in his brain quite clearly for days and the corrected news lit like a shy little finch, flitting away at the slightest movement.
Nothing stays the same like change. The past few weeks have seen him increasingly shorter of breath with just the slightest activity. It all started, of course, just days after his doctor's check-up. Now he needs his oxygen for activities like dressing and undressing, as well as my increasing help for him to do so. Morning and evening routines have relocated from the bedroom to the living room, and we've been looking for a way to have oxygen for him at both ends of the house.
We could go back to plan A, but reject it for the same reason as before: tripping hazard. However, the idea of a central location for the concentrator and using two hoses, one going either direction, seems feasible. Paul checked the connection of the tubing to the machine, and it's a simple pull-off, push-on action of plastic over metal. But it could be made easier.
Ever use two hoses at the same faucet? There's a little thing called a "Y" valve that screws onto the faucet, with each hose screwing onto it, and a lever closing of one or the other hose, or allowing water to flow through both. Oxygen tubing needs one of those. Oh, I admit it's a very special-use item. After all, if oxygen is your only health need, it's fairly simple to trail tubing around with you. No walker to catch in it, good vision to see where it is, strong arms to move it out of the way. Who needs fancy?
Well, my dad does. So Plan D was to call the company providing the concentrator and ask if they had such a thing as a "Y" valve for their tubing. Well, sort of, but it was a connection so one concentrator could feed two tubes simultaneously. He doesn't need 2 tubes. Not at one time. Just one. First one in bed, then one in the living room. As long as he's been wearing it and is "stocked up", he's mobile enough to get to the bathroom or the dining table without it.
On to Plan E then. I ordered extra tubing ("You mean you've never ordered it? It should be replaced at least every 90 days!") (Who knew?) Did I want green or white? Yes. Surprise me. When it arrives late this week or early next, the concentrator will go in the middle of the house, with tubing heading off in both directions, taped to baseboards and down on carpeting under doors, so there's an end with the nose piece by his lift chair and one by his bed. When he goes to bed, the living room piece of tubing will be pulled off and the bedroom piece pushed on. And vice versa. Twice a day. Every day. And his pajamas can go back to staying in the bedroom. And I can sit on the bed next to him and rest my knees periodically while he's getting dressed/undressed.
The gal on the phone offered to let us rent a second concentrator. I'm pretty sure she understood my declining the offer when she informed me that, no, Medicare would not actually pay for a second one. So no Plan F. Or at least not that one. I have no doubt that some day there may have to be some kind of Plan G.
I can wait.
Plan B was to keep the concentrator near his lift chair, the place he spends most of his time. A small amount of the 50 feet of tubing could be played out, giving him moderate mobility while staying connected, and the rest remaining coiled up in a box next to the machine. It didn't seem to want to stay coiled up, so eventually a section of it was loosely "knotted" around a convenient protrusion on the machine, with about 10 feet left to keep track of. He didn't need it while sleeping, and this served well enough, even after he moved in with the family up here.
Plan C was actually a lessening of use. A year on nebulizer meds yielded increasing lung capacity, until the county nurse (who regularly visits as part of our using county home health aids for his care) declared she heard breath sounds all through his lungs, a first for her. They agreed that he would use the oxygen only when he needed it, during those times of high activity.
The afternoon I returned home to hear him declare he didn't need it anymore (at all, to hear him say it) ended with a hasty set of phone calls to find out just what the heck the nurse thought she was doing! Hearing the full, rational explanation was quite helpful, and I got to (try to) pass the corrected information back on to him. Somehow the wrong information stuck in his brain quite clearly for days and the corrected news lit like a shy little finch, flitting away at the slightest movement.
Nothing stays the same like change. The past few weeks have seen him increasingly shorter of breath with just the slightest activity. It all started, of course, just days after his doctor's check-up. Now he needs his oxygen for activities like dressing and undressing, as well as my increasing help for him to do so. Morning and evening routines have relocated from the bedroom to the living room, and we've been looking for a way to have oxygen for him at both ends of the house.
We could go back to plan A, but reject it for the same reason as before: tripping hazard. However, the idea of a central location for the concentrator and using two hoses, one going either direction, seems feasible. Paul checked the connection of the tubing to the machine, and it's a simple pull-off, push-on action of plastic over metal. But it could be made easier.
Ever use two hoses at the same faucet? There's a little thing called a "Y" valve that screws onto the faucet, with each hose screwing onto it, and a lever closing of one or the other hose, or allowing water to flow through both. Oxygen tubing needs one of those. Oh, I admit it's a very special-use item. After all, if oxygen is your only health need, it's fairly simple to trail tubing around with you. No walker to catch in it, good vision to see where it is, strong arms to move it out of the way. Who needs fancy?
Well, my dad does. So Plan D was to call the company providing the concentrator and ask if they had such a thing as a "Y" valve for their tubing. Well, sort of, but it was a connection so one concentrator could feed two tubes simultaneously. He doesn't need 2 tubes. Not at one time. Just one. First one in bed, then one in the living room. As long as he's been wearing it and is "stocked up", he's mobile enough to get to the bathroom or the dining table without it.
On to Plan E then. I ordered extra tubing ("You mean you've never ordered it? It should be replaced at least every 90 days!") (Who knew?) Did I want green or white? Yes. Surprise me. When it arrives late this week or early next, the concentrator will go in the middle of the house, with tubing heading off in both directions, taped to baseboards and down on carpeting under doors, so there's an end with the nose piece by his lift chair and one by his bed. When he goes to bed, the living room piece of tubing will be pulled off and the bedroom piece pushed on. And vice versa. Twice a day. Every day. And his pajamas can go back to staying in the bedroom. And I can sit on the bed next to him and rest my knees periodically while he's getting dressed/undressed.
The gal on the phone offered to let us rent a second concentrator. I'm pretty sure she understood my declining the offer when she informed me that, no, Medicare would not actually pay for a second one. So no Plan F. Or at least not that one. I have no doubt that some day there may have to be some kind of Plan G.
I can wait.
Monday, May 24, 2010
Just Breathe
My dad has been on O2 and a nebulizer for about a year now. It's one of the side effects of having been a 4-pack-a-day man and living to be (now) 96. His quitting smoking is a whole story in itself, which I may do later, but today I want to write about his treatment.
My brother and I had just commented over the phone on how much clearer his mind has been working lately, at least most of the time. There are fewer periods of confusion, better thought processes, more of his sense of humor resurfacing. He's still complete crap on remembering names, but you can't have everything.
So I was a little puzzled the other morning when he announced upon rising that "your gal" had told him he no longer needed his oxygen. "Your gal" is his way of referring to his home health aids, since he can't remember names, and I'm the one who set them up for him. They bathe him, clean up the house, change his bedding, and do some continuation on his physical therapy now that Medicare quit covering it. We are going through our county now, and as a result the county nurse also stops by regularly to monitor him and supervise any changes in his care. I knew she had stopped by the day before since she'd left some paperwork on the table.
I just couldn't figure out what she had to do with his taking his O2, since his doctor was the one who prescribed it for him, and had just renewed it and the nebulizer for another year a few weeks before. So I decided to call her and let her explain whatever it was she had really told him. Meanwhile we got his tubing on him for the day as usual, and I promised I would report back to him that evening on what was going on.
When she returned my call, she confirmed that he wasn't completely confused. She had been monitoring his blood O2 levels on her visits, and last week, without O2 and just sitting in his chair, they were at 96. With O2, they rose to 98. For perspective, when they drop to 88 or 89 is when folks start to worry and add O2. That was his sitting level at the doctor's office when it first got prescribed, and it dropped to 86 after walking. These new results were excellent, and an indication of very real progress in his health, not something one would suspect at his age and given his history. So she had, in fact, told him he didn't need the O2 24 hours a day.
That garnered a discussion of when he actually used it, since it was only while sitting in his chair, or using portable tanks while in the car. He didn't use it while eating, or going to the bathroom, or out on his scooter rides, or overnight. The doctor originally told him to use it whenever he was active. He'd started with it as often as possible, but that required long coils of plastic tubing stretching throughout the house, in itself a tripping/falling hazard with potentially much worse outcomes than time away from enriched air, particularly given his vision. So we compromised on his taking it while sitting in his recliner, where he spends most of his day. Then he's "stocked up" for those periods of activity, and "recharged" afterward.
His set-up is a machine back in the corner behind his chair which condenses the O2 from regular air and pushes it through the tubing to the two little prongs which sit in his nostrils. On top of that is a 2nd machine which does the same thing for filling his 2 little portable tanks. Finally, there's a big monster tank in his bedroom in a stand in the corner for emergency use, like when the power goes out. It's supposed to last two days. There's also a no-smoking warning sign about O2 use in the front door, and of course I informed the local fire department when we moved him in. His tubing comes from behind and beside his chair, long enough he can move slightly but not long enough to trip him.
I asked the nurse about his improvement, which was not just his rising O2 levels, but her now being able to hear breath sounds all the way to the bottom of his lungs, something he'd not been able to produce when she first visited him several months ago. Was it the nebulizer? She asked me what kind of meds he was on, and I told her, generic for DuoNeb. After sharing a laugh over not remembering the exact generic name for the ipr...(insert lots of letters here)... bromide, she informed me that the albuterol was a "right now" kind of bronchio-dialator, and the unpronounceable one was longer acting, and that the pair likely had made the difference.
Did the improvement mean he didn't need to take the nebulizer any more? That would be the best kind of news for my dad, since he hates taking the stuff and will "forget" any time he can get away with it. It really brings out the child in him. No, he still needs to take that. Three times a day ideally, twice if we can't force it. So, I'll continue nagging and reminding and bribing. Tonite, for example, it was a dish of ice cream as soon as he finished.
At least he did.
My brother and I had just commented over the phone on how much clearer his mind has been working lately, at least most of the time. There are fewer periods of confusion, better thought processes, more of his sense of humor resurfacing. He's still complete crap on remembering names, but you can't have everything.
So I was a little puzzled the other morning when he announced upon rising that "your gal" had told him he no longer needed his oxygen. "Your gal" is his way of referring to his home health aids, since he can't remember names, and I'm the one who set them up for him. They bathe him, clean up the house, change his bedding, and do some continuation on his physical therapy now that Medicare quit covering it. We are going through our county now, and as a result the county nurse also stops by regularly to monitor him and supervise any changes in his care. I knew she had stopped by the day before since she'd left some paperwork on the table.
I just couldn't figure out what she had to do with his taking his O2, since his doctor was the one who prescribed it for him, and had just renewed it and the nebulizer for another year a few weeks before. So I decided to call her and let her explain whatever it was she had really told him. Meanwhile we got his tubing on him for the day as usual, and I promised I would report back to him that evening on what was going on.
When she returned my call, she confirmed that he wasn't completely confused. She had been monitoring his blood O2 levels on her visits, and last week, without O2 and just sitting in his chair, they were at 96. With O2, they rose to 98. For perspective, when they drop to 88 or 89 is when folks start to worry and add O2. That was his sitting level at the doctor's office when it first got prescribed, and it dropped to 86 after walking. These new results were excellent, and an indication of very real progress in his health, not something one would suspect at his age and given his history. So she had, in fact, told him he didn't need the O2 24 hours a day.
That garnered a discussion of when he actually used it, since it was only while sitting in his chair, or using portable tanks while in the car. He didn't use it while eating, or going to the bathroom, or out on his scooter rides, or overnight. The doctor originally told him to use it whenever he was active. He'd started with it as often as possible, but that required long coils of plastic tubing stretching throughout the house, in itself a tripping/falling hazard with potentially much worse outcomes than time away from enriched air, particularly given his vision. So we compromised on his taking it while sitting in his recliner, where he spends most of his day. Then he's "stocked up" for those periods of activity, and "recharged" afterward.
His set-up is a machine back in the corner behind his chair which condenses the O2 from regular air and pushes it through the tubing to the two little prongs which sit in his nostrils. On top of that is a 2nd machine which does the same thing for filling his 2 little portable tanks. Finally, there's a big monster tank in his bedroom in a stand in the corner for emergency use, like when the power goes out. It's supposed to last two days. There's also a no-smoking warning sign about O2 use in the front door, and of course I informed the local fire department when we moved him in. His tubing comes from behind and beside his chair, long enough he can move slightly but not long enough to trip him.
I asked the nurse about his improvement, which was not just his rising O2 levels, but her now being able to hear breath sounds all the way to the bottom of his lungs, something he'd not been able to produce when she first visited him several months ago. Was it the nebulizer? She asked me what kind of meds he was on, and I told her, generic for DuoNeb. After sharing a laugh over not remembering the exact generic name for the ipr...(insert lots of letters here)... bromide, she informed me that the albuterol was a "right now" kind of bronchio-dialator, and the unpronounceable one was longer acting, and that the pair likely had made the difference.
Did the improvement mean he didn't need to take the nebulizer any more? That would be the best kind of news for my dad, since he hates taking the stuff and will "forget" any time he can get away with it. It really brings out the child in him. No, he still needs to take that. Three times a day ideally, twice if we can't force it. So, I'll continue nagging and reminding and bribing. Tonite, for example, it was a dish of ice cream as soon as he finished.
At least he did.
Friday, May 21, 2010
Stretching
I've finally decided the worst of the rotator cuff tear is behind me. I have cut way back on the Ibuprofin levels, without the bone-deep ache in the shoulder, penetrating the elbow, and extending to the wrist. I can raise the arm straight forward to horizontal without grimacing - much. Armrests on chairs or in the car, while always in just the wrong spot, no longer cause pain as they make me move the shoulder. I can start doing things with the left hand again, sometimes even parting and brushing my hair after the shower. Of course, that's after standing so the hot water hits the shoulder during most of the shower, and raising the arm, elbow bent, to overhead at least once. Just today I started closing the car door with the left arm again, although I've perfected the art of reaching across myself with the right to do so. It involves hooking the knee under the steering wheel while I overbalance. I wouldn't want to land nose down on the asphalt.
There's still much I can't do. I can't roll over in bed to lay on that side, so sleeping is still a progression from bed to recliner to bed to recliner as I need to change position from the pressure on one spot. Needless to say, I'm sleep deprived. (However, the dog is adapting well to my movements, no longer thinking each signals an opportunity for him to get to go outside in the middle of the night.) I can't tuck a box under the left arm and carry it, though I can support it from underneath in conjunction with the other arm, or just for long enough for the right arm to reach up and pull the hatch shut. And I can't lift the arm, not well. Not hardly at all, in fact.
That's important. I recall clearly the Doctor's instruction from the first time, telling me to finger-walk up the wall until the arm was straight up, for if I didn't, the shoulder would freeze in place. I don't want that. But there's another reason, and that's my skin. The left arm has been down so long that my armpit doesn't get a chance to dry out.
Sure, go ahead and laugh! I would. Except that the skin is getting irritated, rubbed by the elastic in the bra, and staying gooey from the antiperspirant even after I get home from work and change. It itches, It needs air. And did I mention it itches?
Problem is, I need help getting it up. The arm, of course, what did you think I meant? So I asked Paul to help me lift it, twice a day at least, first straight out to horizontal, then to vertical, and back down again. Slowly, stretching everything. It's easy when he does it. On my own, I can raise it to about the 8:00 position, to the side, or 9:00 straight forward. So we'll stretch it, and I'll start working the muscles again, and I'll get my arm back.
Mostly, anyway.
There's still much I can't do. I can't roll over in bed to lay on that side, so sleeping is still a progression from bed to recliner to bed to recliner as I need to change position from the pressure on one spot. Needless to say, I'm sleep deprived. (However, the dog is adapting well to my movements, no longer thinking each signals an opportunity for him to get to go outside in the middle of the night.) I can't tuck a box under the left arm and carry it, though I can support it from underneath in conjunction with the other arm, or just for long enough for the right arm to reach up and pull the hatch shut. And I can't lift the arm, not well. Not hardly at all, in fact.
That's important. I recall clearly the Doctor's instruction from the first time, telling me to finger-walk up the wall until the arm was straight up, for if I didn't, the shoulder would freeze in place. I don't want that. But there's another reason, and that's my skin. The left arm has been down so long that my armpit doesn't get a chance to dry out.
Sure, go ahead and laugh! I would. Except that the skin is getting irritated, rubbed by the elastic in the bra, and staying gooey from the antiperspirant even after I get home from work and change. It itches, It needs air. And did I mention it itches?
Problem is, I need help getting it up. The arm, of course, what did you think I meant? So I asked Paul to help me lift it, twice a day at least, first straight out to horizontal, then to vertical, and back down again. Slowly, stretching everything. It's easy when he does it. On my own, I can raise it to about the 8:00 position, to the side, or 9:00 straight forward. So we'll stretch it, and I'll start working the muscles again, and I'll get my arm back.
Mostly, anyway.
Saturday, April 24, 2010
DOT Physical
Those of you who've been following this blog will understand why I found the Dr.'s comment so funny. But first, a little background.
In order to drive commercially, I am required to get a DOT physical every year. Normally it's every two, but since my blood pressure is being medicated, I'm required to do it every year. Lately our company has been really attentive to the date when the renewal is due, and if a day lapses, tough luck, you're out. Bring in the proof. Last night was my date to stop in.
My vision was checked, the one thing I had been a little unsure of before last weekend. Road signs had been getting blurry, and I figured after about 5 years I was due to get new glasses. The questions for the optometrist were whether I would now need glasses to drive (not yet), and whether the blurriness was the first signal of my own onset of macular degeneration, a particular nightmare of mine with Dad's history. Luckily, no sign of that, but I've gotten an astigmatism and the barest inkling of cataracts starting, something likely not to be noticeable until years after retirement. WHEW! I went into the physical without concern.
They take vitals, check hearing, go over your illness and injury history. I had to do knee bends to prove that I was still capable, even with my handicap status, of checking the undercarriage of my bus during the safety check. I explained my bus was a hatchback, but he persisted in thinking I drove for the school system. Whatever. I passed.
His particular concern was my rotator cuff injury. Could I really handle a steering wheel with enough strength to maintain control of a vehicle? We went through some strength and range of motion tests, which I also passed, though not without pain. Yesterday had been a relatively good day, the first one in three weeks where I had started to think it was finally healing. Good enough that I'm starting to back off on the ibuprofin levels.
But before going through the testing of my arm, while noticing I was holding it in a least-painful position and reading my chart for what was going on, he turned and asked me, "Are you sure you want to take your DOT physical today? Don't you want to wait until after you've recovered from the surgery?"
Surgery? My young doctor got a quick lesson in the facts of life.
In order to drive commercially, I am required to get a DOT physical every year. Normally it's every two, but since my blood pressure is being medicated, I'm required to do it every year. Lately our company has been really attentive to the date when the renewal is due, and if a day lapses, tough luck, you're out. Bring in the proof. Last night was my date to stop in.
My vision was checked, the one thing I had been a little unsure of before last weekend. Road signs had been getting blurry, and I figured after about 5 years I was due to get new glasses. The questions for the optometrist were whether I would now need glasses to drive (not yet), and whether the blurriness was the first signal of my own onset of macular degeneration, a particular nightmare of mine with Dad's history. Luckily, no sign of that, but I've gotten an astigmatism and the barest inkling of cataracts starting, something likely not to be noticeable until years after retirement. WHEW! I went into the physical without concern.
They take vitals, check hearing, go over your illness and injury history. I had to do knee bends to prove that I was still capable, even with my handicap status, of checking the undercarriage of my bus during the safety check. I explained my bus was a hatchback, but he persisted in thinking I drove for the school system. Whatever. I passed.
His particular concern was my rotator cuff injury. Could I really handle a steering wheel with enough strength to maintain control of a vehicle? We went through some strength and range of motion tests, which I also passed, though not without pain. Yesterday had been a relatively good day, the first one in three weeks where I had started to think it was finally healing. Good enough that I'm starting to back off on the ibuprofin levels.
But before going through the testing of my arm, while noticing I was holding it in a least-painful position and reading my chart for what was going on, he turned and asked me, "Are you sure you want to take your DOT physical today? Don't you want to wait until after you've recovered from the surgery?"
Surgery? My young doctor got a quick lesson in the facts of life.
Thursday, April 15, 2010
Nothing Hurts Yet
"The time is 5:23 A.M."
At least that's what I think I hear frpm the tinny voice over the baby monitor as my dad checks his watch. I had been sleeping. Now I'm not. Thanks, Dad.
The alarm is set to go off at 6:00 A.M., really in about 20 minutes because I set the time ahead. It gives me a few more minutes in the morning, and as often as the power goes out around here, it's just simpler to reset everything that way. At any rate, 20 minutes is how much shorter of sleep I'm going to be than I already was. There's not enough time to go back to sleep.
I take a mental inventory. Nothing hurts yet.
It won't last.
I'll have to get up soon, because my bladder woke up as soon as I did. I've learned there are consequences to not paying attention. And since I need to get up, the dog gets to go out. It's my rule, and it's only fair. The only problem is having to stand there and call him to come in again. That wakes me up enough to make getting to sleep again a good 20-minute proposition. Not enough time left. Can I postpone a few minutes?
My right hip starts to inform me I've been laying in this position quite long enough, thank you. I can't roll over to relieve the pressure. I'm currently sleeping in the recliner in my room. It puts the least pressure on my rotator cuff injury to the left shoulder, and I usually end up there, sometimes only moments after lying flat on the bed, left side up. It keeps the shoulder immobile, and prevents me from trying to roll over, something that lately has become a very bad idea. That's how I injured it in the first place, rolling over in bed. At least right now, with my having slept for hours in the chair, the shoulder doesn't have that deep ache that I went to bed with.
My knees aren't hurting yet either. I haven't rolled over for hours, something that often wakes my up from pain as one or other grinds from the torque of the rolling process. I actually wake up to hear myself saying, "Ow." Plus, I haven't stepped on either one yet. For right now, it's a pretty peaceful time.
Oh wait, leg cramp. The right foot wants to go to impossible places, and I have to pull against it to make it stop. Got it... nope, there it goes again. Done? Nope, there's another one. Dang, might as well get up now! I still resist fully waking as much as possible, and decide to postpone until full morning trying to assess whether I'm short of calcium or potassium to cause these cramps. Oh heck, even as soon as I decide that, the answer rolls in: calcium, probably. My diet has been fairly high in potassium lately. I take supplements in both, since the diuretics for my BP tend to flush them from my system before I can get adequate use of them.
In surrender, I toss off the lap blanket - remembering to use only the right hand to do it - kick down the foot rest, sit up, get up and go let the dog out on my way to the bathroom. On my way I glance at the clock on the nightstand, something I can't see from the recliner. It reads 4:24. Obviously what I thought I heard was wrong, but that's good news. Time enough to get back to sleep again, if I'm careful not to really wake myself up in the next five. I let the dog out and note it's pouring out. Great for the yard, tough luck for the dog, but at least he'll come back in faster.
By the time I get back, however, all the usual places hurt, and it's too soon to take any Ibuprofin for the day. Snatching a Milk Bone on my way back to bed, the dog's reward for coming back inside, I decide to head for the bed this time, since the pressure point in my hip hasn't really gone. It'll be the same hip, just a different angle. I carefully pull up the covers using only the right hand, put my head on the pillow...
And wake what seems an instant later to a pair of talking heads on the radio discussing something I have no interest in at the moment, which means it's great at driving me from my bed into the morning's routine, starting with another bathroom trip. This one, however, will end in Ibuprofin. By the time I get there, I'll appreciate that fact. For just a moment, however, I can reflect that nothing hurts yet.
At least that's what I think I hear frpm the tinny voice over the baby monitor as my dad checks his watch. I had been sleeping. Now I'm not. Thanks, Dad.
The alarm is set to go off at 6:00 A.M., really in about 20 minutes because I set the time ahead. It gives me a few more minutes in the morning, and as often as the power goes out around here, it's just simpler to reset everything that way. At any rate, 20 minutes is how much shorter of sleep I'm going to be than I already was. There's not enough time to go back to sleep.
I take a mental inventory. Nothing hurts yet.
It won't last.
I'll have to get up soon, because my bladder woke up as soon as I did. I've learned there are consequences to not paying attention. And since I need to get up, the dog gets to go out. It's my rule, and it's only fair. The only problem is having to stand there and call him to come in again. That wakes me up enough to make getting to sleep again a good 20-minute proposition. Not enough time left. Can I postpone a few minutes?
My right hip starts to inform me I've been laying in this position quite long enough, thank you. I can't roll over to relieve the pressure. I'm currently sleeping in the recliner in my room. It puts the least pressure on my rotator cuff injury to the left shoulder, and I usually end up there, sometimes only moments after lying flat on the bed, left side up. It keeps the shoulder immobile, and prevents me from trying to roll over, something that lately has become a very bad idea. That's how I injured it in the first place, rolling over in bed. At least right now, with my having slept for hours in the chair, the shoulder doesn't have that deep ache that I went to bed with.
My knees aren't hurting yet either. I haven't rolled over for hours, something that often wakes my up from pain as one or other grinds from the torque of the rolling process. I actually wake up to hear myself saying, "Ow." Plus, I haven't stepped on either one yet. For right now, it's a pretty peaceful time.
Oh wait, leg cramp. The right foot wants to go to impossible places, and I have to pull against it to make it stop. Got it... nope, there it goes again. Done? Nope, there's another one. Dang, might as well get up now! I still resist fully waking as much as possible, and decide to postpone until full morning trying to assess whether I'm short of calcium or potassium to cause these cramps. Oh heck, even as soon as I decide that, the answer rolls in: calcium, probably. My diet has been fairly high in potassium lately. I take supplements in both, since the diuretics for my BP tend to flush them from my system before I can get adequate use of them.
In surrender, I toss off the lap blanket - remembering to use only the right hand to do it - kick down the foot rest, sit up, get up and go let the dog out on my way to the bathroom. On my way I glance at the clock on the nightstand, something I can't see from the recliner. It reads 4:24. Obviously what I thought I heard was wrong, but that's good news. Time enough to get back to sleep again, if I'm careful not to really wake myself up in the next five. I let the dog out and note it's pouring out. Great for the yard, tough luck for the dog, but at least he'll come back in faster.
By the time I get back, however, all the usual places hurt, and it's too soon to take any Ibuprofin for the day. Snatching a Milk Bone on my way back to bed, the dog's reward for coming back inside, I decide to head for the bed this time, since the pressure point in my hip hasn't really gone. It'll be the same hip, just a different angle. I carefully pull up the covers using only the right hand, put my head on the pillow...
And wake what seems an instant later to a pair of talking heads on the radio discussing something I have no interest in at the moment, which means it's great at driving me from my bed into the morning's routine, starting with another bathroom trip. This one, however, will end in Ibuprofin. By the time I get there, I'll appreciate that fact. For just a moment, however, I can reflect that nothing hurts yet.
Tuesday, March 2, 2010
Confusions
The Epley maneuver does work wonders for vertigo, when you can do it right. All the turning alnd holding and stuff, that's not the problem. The problem is determining which side is the affected side. They never explain that. When the room spins when you roll over on your left, does that mean the left or right side is the affected one? And when it spins again when you roll back, which side is it then? How about when it spins when you bend forward to pick something off the ground, now which side?
I compromise: I do the maneuver both ways. One has to be right, wouldn't you think? If I'm lucky, this works, meaning, I think, that I picked the correct side last and now everything's back in place. If not, well, I have been known to throw up.
Meclazine helps. In fact, it's so strong, I take only half a pill. This keeps me from sleeping behind the wheel. I don't just take it after throwing up, or seriously wanting to. After vertigo, there is a period where one is hyper-sensitive to one's head position. Not dizzy, just hyper aware. It commands your attention. It reminds you of where you've just been and threatens to take you back there. Meclazine cuts through that and lets you focus on other things, like the color of the light just ahead of you. This is a good thing.
* * * * *
I found another stupid sign yesterday, and trust me, I really wasn't in the mood for it. It was the end of a long day of walking, lots of short runs in long places. In other words, little rest between long walks. Everything from the knees down ached. This is when the last stop of the day just has to go to a patient in a nursing home. Well, to the floor nurse who's the only person authorizes to sign for his meds. And of course it's suppertime. Not only are all the patients out in the halls and wanting something from whomever passes, but the staff are all busy. You can't even find the wrong staffer to point you to where the right staffer is for that signature. I'm already grumpy walking in the door, just thinking about it.
Sure enough, our patient is up on third floor. There on the column between elevators is this sign: "Push up and down buttons to call elevator". Huh? Several possibilities hold. Either it's because the patients are so completely senile that, while they can still read, they don't know how elevators work. Or it's one of those gimmicks that keep the senile folk from escaping to another part of the building. Some places make you punch in the year on a keypad before the elevator works. Maybe here you have to punch both buttons at once. Or maybe it's just another stupid sign.
I try pushing just the up button. The elevator on my right opens its door and two people step out. This doesn't really answer my question: they might have brought it, not my button-push. On third floor, I ask a passing staffer which way the sign is meant. Do you really have to push both buttons? She says, "No." I just can't resist, "Oh, so it really should read 'or' instead of 'and'."
She doesn't get it.
On the way out, passing the front desk, I overhear a conversation between a little old lady in a wheelchair and the sweet young thing behind the desk.
"I need you to put my shoe on."
"I just did,"
"No you didn't, I need my shoe on."
I looked. Her foot is sticking straight out, and sure enough, the shoe is on, one of those black leather-look things with a pair of velcro straps to fasten it.
"Yes, I did."
"No you didn't."
"Yes, I just did. Look at your foot. Your shoe is on it. I just put it there."
"I need you to put my shoe on."
Maybe she's the one who wrote the sign.
I compromise: I do the maneuver both ways. One has to be right, wouldn't you think? If I'm lucky, this works, meaning, I think, that I picked the correct side last and now everything's back in place. If not, well, I have been known to throw up.
Meclazine helps. In fact, it's so strong, I take only half a pill. This keeps me from sleeping behind the wheel. I don't just take it after throwing up, or seriously wanting to. After vertigo, there is a period where one is hyper-sensitive to one's head position. Not dizzy, just hyper aware. It commands your attention. It reminds you of where you've just been and threatens to take you back there. Meclazine cuts through that and lets you focus on other things, like the color of the light just ahead of you. This is a good thing.
* * * * *
I found another stupid sign yesterday, and trust me, I really wasn't in the mood for it. It was the end of a long day of walking, lots of short runs in long places. In other words, little rest between long walks. Everything from the knees down ached. This is when the last stop of the day just has to go to a patient in a nursing home. Well, to the floor nurse who's the only person authorizes to sign for his meds. And of course it's suppertime. Not only are all the patients out in the halls and wanting something from whomever passes, but the staff are all busy. You can't even find the wrong staffer to point you to where the right staffer is for that signature. I'm already grumpy walking in the door, just thinking about it.
Sure enough, our patient is up on third floor. There on the column between elevators is this sign: "Push up and down buttons to call elevator". Huh? Several possibilities hold. Either it's because the patients are so completely senile that, while they can still read, they don't know how elevators work. Or it's one of those gimmicks that keep the senile folk from escaping to another part of the building. Some places make you punch in the year on a keypad before the elevator works. Maybe here you have to punch both buttons at once. Or maybe it's just another stupid sign.
I try pushing just the up button. The elevator on my right opens its door and two people step out. This doesn't really answer my question: they might have brought it, not my button-push. On third floor, I ask a passing staffer which way the sign is meant. Do you really have to push both buttons? She says, "No." I just can't resist, "Oh, so it really should read 'or' instead of 'and'."
She doesn't get it.
On the way out, passing the front desk, I overhear a conversation between a little old lady in a wheelchair and the sweet young thing behind the desk.
"I need you to put my shoe on."
"I just did,"
"No you didn't, I need my shoe on."
I looked. Her foot is sticking straight out, and sure enough, the shoe is on, one of those black leather-look things with a pair of velcro straps to fasten it.
"Yes, I did."
"No you didn't."
"Yes, I just did. Look at your foot. Your shoe is on it. I just put it there."
"I need you to put my shoe on."
Maybe she's the one who wrote the sign.
Friday, February 5, 2010
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.
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.
Friday, January 29, 2010
Drippy Nasal Post
I have a drippy nasal post. Yes, it's gross. Stop reading now if that upsets you.
What? You've never heard of one? Of course not. It's just how my mind plays with words sometimes. Perhaps you've heard of a post-nasal drip? That's really what it is, and I've only had it for a bit over a year. It's minor, really, and related to allergies, or mock-allergies, like dermatographism. In order to deal with that condition, I've been taking Claritin or its generic substitute for several years. Daily. Otherwise life is just so itchy that I can't stand it. With the medication it's only moderately itchy and only on occasion. Mostly.
Eventually the body fights back. Caffeine no longer keeps you awake, the painkiller doesn't stop the pain, and the dermatographism symptoms return. Those nice dry nasal passages that came as a side-effect of the Claritin find a new equilibrium as well. Drip. Drip. Drain. Tickle. Cough cough.
The cough started in October. Sixteen months back, that October. It came on like a cold with no other symptoms, and when I get a real cold, I go full-spectrum. I went to the doctor anyway, having managed to cough long and hard enough to pull a chest muscle. After about ten days on a cough suppressant and a muscle relaxer (that amazingly didn't make me sleepy and impair my driving) my chest felt better. I still was coughing, but eventually even that found its own equilibrium. And I learned mostly to ignore it.
Lately it's decided to tweak things just a bit more, so when I first get up in the morning, and just after I take my morning pills, it makes me cough to the point of nausea. If I'm lucky, and can hold very very still, I can manage to get through it without event. Sometimes I'm not so lucky.
No, I won't describe it. You'll thank me.
I recently switched to a different allergy medication, still OTC because I can't afford the really new ones that haven't come off patent. It's still too soon to really tell, but I haven't noticed any difference in any of the symptoms, the ones I take it for, or the ones that come along for the ride.
I do get to explain to folks that I'm not contagious, a statement met with many a dubious eye during the height of the H1N1 scare. I get to explain to my dad repeatedly that I'm not actually sick or coming down with something. (His memory is not what it was: I pretty much get to repeat that daily.) Mostly it's just an annoyance that I try to ignore, even as I think I should take out stock in my favorite cough drop company (Halls). The annoyance is kind of like a filter through which I live my life.
So with all this, perhaps you'll forgive my little twisting of the terms in referring to my drippy nasal post. There's got to be some humor in it somewhere.
What? You've never heard of one? Of course not. It's just how my mind plays with words sometimes. Perhaps you've heard of a post-nasal drip? That's really what it is, and I've only had it for a bit over a year. It's minor, really, and related to allergies, or mock-allergies, like dermatographism. In order to deal with that condition, I've been taking Claritin or its generic substitute for several years. Daily. Otherwise life is just so itchy that I can't stand it. With the medication it's only moderately itchy and only on occasion. Mostly.
Eventually the body fights back. Caffeine no longer keeps you awake, the painkiller doesn't stop the pain, and the dermatographism symptoms return. Those nice dry nasal passages that came as a side-effect of the Claritin find a new equilibrium as well. Drip. Drip. Drain. Tickle. Cough cough.
The cough started in October. Sixteen months back, that October. It came on like a cold with no other symptoms, and when I get a real cold, I go full-spectrum. I went to the doctor anyway, having managed to cough long and hard enough to pull a chest muscle. After about ten days on a cough suppressant and a muscle relaxer (that amazingly didn't make me sleepy and impair my driving) my chest felt better. I still was coughing, but eventually even that found its own equilibrium. And I learned mostly to ignore it.
Lately it's decided to tweak things just a bit more, so when I first get up in the morning, and just after I take my morning pills, it makes me cough to the point of nausea. If I'm lucky, and can hold very very still, I can manage to get through it without event. Sometimes I'm not so lucky.
No, I won't describe it. You'll thank me.
I recently switched to a different allergy medication, still OTC because I can't afford the really new ones that haven't come off patent. It's still too soon to really tell, but I haven't noticed any difference in any of the symptoms, the ones I take it for, or the ones that come along for the ride.
I do get to explain to folks that I'm not contagious, a statement met with many a dubious eye during the height of the H1N1 scare. I get to explain to my dad repeatedly that I'm not actually sick or coming down with something. (His memory is not what it was: I pretty much get to repeat that daily.) Mostly it's just an annoyance that I try to ignore, even as I think I should take out stock in my favorite cough drop company (Halls). The annoyance is kind of like a filter through which I live my life.
So with all this, perhaps you'll forgive my little twisting of the terms in referring to my drippy nasal post. There's got to be some humor in it somewhere.
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