Sunday, September 14, 2008
State of Grace
Movement for 9/14/08:
- So far, today, Mom has stood well, moved well, but she's seemed a bit winded. I've upped her O2 most of the day. Just before her nap, after some observations covered over at The Dailies in the Medication Changes section, I decided to give her 10 mg furosemide. I also decided, considering that she still appeared to be a bit breathless even while sitting and on 5/lpm O2, that it would be a good idea to wheel her into the bathroom and into bed. Her spirit and will were high, though, so I figured I'd better talk her into this.
I stood in front of her, sitting in her rocker shielded by her TV table. "Mom," I said, spreading my arms for dramatic effect, "here's my dilemma."
"Most people call that their body," she said, her eyes twinkling and the corners of her mouth on the verge of an ironic smile.
I laughed. "Well, mine's a dilemma, today," I said. "I know you've been moving well, but I'm concerned that your breathless has continued even when you've been sitting."
She nodded confirmation.
"So, I'm thinking, even though you're fine on your feet, maybe it would be a good idea to wheel you into the bathroom and your bedroom for your nap. I know you don't like to do this, but I don't want you to get so winded that, halfway through the trek, you discover you can't make it. Do you see what I mean?"
"Yeees..." she said, making it obvious that she didn't completely believe my assessment of her abilities.
"So, what do you think? Do you mind if we use the wheelchair?"
"No, I think that'll be all right." It was obvious from her tone that she was merely humoring me but, I decided, that's good enough.
In the bathroom, my mind still whirring about what to do about her fluid retention and breathlessness, I announced that tonight was a good night to finish off the Appetizer Dinner ingredients from night before last. "Lots of sodium and potassium," I said, "and you'll need that to counteract the furosemide."
She grinned. "Oh, I don't need a reason to eat appetizers," she said.
"So, pineapple upside down cake or chocolate squares for dessert?"
"Do you even need to ask?" she chided.
Chocolate squares it will be.
She transferred well, so I know she's not having any limb problems. Once she made it to her bed, despite being wheeled, she was still winded. So, it was a good decision. We'll see how she's feeling after her nap.
In the meantime, the reason I labeled this post "State of Grace" is that, when it was all over and she was settled in bed, I did an auto review of everything that had happened so far today:- Noting, early, the high blood pressure trend, the breathlessness, the slight edema and the "kecking";
- regardless of what else I was doing, keeping a keen third eye focused on Mom;
- adjusting conditions, sometimes moment to moment, to address this symptom or that symptom;
- keeping Mom "in the loop" in order to test my observations, allow her to be aware of my concerns and why I was tending so closely to her and allow her to participate in her care;
- consulting with her on strategy, especially the wheelchair use, that I knew she wouldn't particularly like;
- automatically adjusting meds and meals to handle circumstances;
- performing, in every moment, so smoothly that neither she nor I felt as though any part of our day, individually or "corporately" experienced, has been out of whack.
"Wow," I thought, quickly scanning through all the years of experience I've had being my mother's companion and caregiver. "I'm constantly in stride, now!" Good feeling.
We'll see how the evening progresses for Mom. It usually takes the minor doses of furosemide I give my mother several hours, sometimes a day or a bit more, to work, so she may still be winded tonight. In the meantime, I know it'll be an even keeled evening, because, well, we're living in a state of grace. - She awoke on her own from her nap much earlier than the time she'd asked me to awaken her. She alerted me that she was up by walking, with environmental support, from her bedroom to the banister, hanging over it and asking me, while I was publishing the first part of this post, "So, what're you doing for fun?"
I was surprised but pleased. This happens every once in awhile, and it always pleases me that she's still capable of mobilizing on her own. I leapt to my feet, headed up the foyer steps and noticed that while she was standing at the banister, leaning heavily on it, her knees were sinking. I directed her to "hang on" and headed to get the wheelchair. It was obvious she wasn't going to be able to stay on her feet long enough to head back down our short hall for the bathroom. From that point on, she spent the evening being wheeled around in the chair, although she did transfers with no problem. She opted for bed early, though, for her, and was clearly tired. I wheeled her into the bathroom. She insisted, though, that she could stand at the sink to brush her teeth, and did. She also insisted that she didn't need the wheelchair to get to bed. She didn't, but it was a close call. I'd say it's about 25 feet from the sink in the bathroom to her bed. I had her stop every few steps and "stretch up", just to make sure her legs were able to get her to the bed.
# posted by Gail Rae @ 19:32 email...
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