Saturday, September 27, 2008
Restless Night, Somewhat Challenging Day
Movement for 9/27/08:
- Although she awoke "on time" at 1300, which I didn't expect, she was clearly hung over from a restless night. I asked her, as I'd vowed to do, if she wanted to try walking to the bathroom, but she didn't, thank the gods. I'm not sure how I would have responded if she'd said, "Yes." Transfers have been harder than yesterday but not nearly as hard as they were pre-Levaquin. Mostly, I think, she's just been tired; last night was a hard night. She was awake longer than I expected, though: Until 1730, which was when she actually sat on the bed pre-nap. She was involved in a TCM showing of Close Encounters of a Third Kind, though, a movie which always fascinates her. Despite the fact that she looked like she could use a nap about an hour before the movie was done, and I suggested it, since we'd taped the movie, she was reluctant to leave the viewing. When we finally got her into the bathroom for her pre-nap ritual, her legs weren't moving very well, but they weren't moving badly, either, and she wasn't frustrated by this; she just commented that "they've already gone to bed." I suspect she was right. She had no trouble standing while I cleaned her after her bowel movement. I'm not going to push anything for the rest of the day, though; I'm not even going to question her about making it a wheel chair night.
I'll report on our evening later. - Despite a restful nap it was obvious that she was still hung over from her restless night. Her energy level was low, so we stuck with the wheelchair. She had moderate trouble transferring, although she chose to transfer to her rocker in the living room, refusing my suggestion that she spend the evening in the wheelchair. She was also able to lift herself up partially while I pulled her slacks down in order to rub down her legs, and she raised herself, using the arms of the rocker, in order to transfer to the wheelchair for bedtime. So, her strength, I think, is recovering, it's just that she was phenomenally tired yesterdday. Even so, she wasn't interested in going to bed until 0100.
Much, Much Better, Thank You!
Movement for 9/26/08:
- The untested diagnosis of pneumonia was probably correct, as, by the time she awoke today (I gave her an extra hour beyond her usual 12-hour-sleep-mark) the "thick tongue" had completely subsided and her strength in her legs was obviously returning. She looked better, too. We stuck with the wheelchair, today, and may do so, tomorrow, I'm not sure. However, transfers were easy, Mom moved her feet without much thought, even raised herself on her own from her rocking chair twice, once as we headed her in for her nap and once when it was time to rub her legs down. She slept more than usual, today; so much that we weren't able to get in her 3rd breathing treatment, but I'm not worried about this. She is, apparently, recovering, from what probably is pneumonia.
Ai, yi, yi!
Movement for 9/25/08:
- Although some of the edema subsided, my mother's weakness, especially in her legs, escalated throughout the day. It was, needless to say, a complete wheel chair day, yet again, with so much difficulty transferring that in a couple of cases I literally lifted and swung her from chair to chair. She was insistent, though that she wanted to make the transfer, for instance, from wheel chair to dinette chair. I will be reporting much more about all this in the journal, as all the significant developments (including tongue thickening in the late afternoon) led, in the afternoon and early evening, to two phone consults with the Hospice RN on call and a preemptive prescription for antibiotics under the assumption that she had developed pneumonia.
- Within four hours after her first dose of Levaquin 500 mg, by the time she went to bed she was feeling better and appeared to be getting her strength back, although neither of us was confident enough about her strength to allow any walking, walkering or time on her feet.
Wednesday, September 24, 2008
Yet Another Leg Collapse
Movement for 9/24/08:
- I awoke at 0630 to make sure I was ready for the Construction Company when they arrived to do more work. At about 0640 I peaked in on Mom. She was sitting on the floor against her bed, her underwear around her knees. I asked her what she was doing there. She said she was "cleaning out [my bureau] drawers." She claimed she didn't fall, that she "put" herself down there. I suspect that she may very well have attempted to get up and open a drawer for cleaning, then collapsed to the floor. She was not hurt and fairly mobile, as it turns out; so much so that when I returned from calling Hospice and having them contact the non-emergent paramedics, she had turned herself to her knees facing the bed and was clamoring to get herself back up on the bed; sort of like she was leaning over her bed praying. The Hospice Nurse recommended that I get her back on the floor, but that actually seemed impossible. The paramedics got her squared away in bed, though, with no problem. She seemed fine; no new bruises. She has, though, through the first half of her day, continued to have significant problems with transferring and her lower legs continue to be swollen; not hugely, but significant for her. Despite this, I ended up giving her 500 mg acetaminophen with her breakfast, just to keep any problems at bay. Today, needless to say, has been and will continue to be a full wheelchair day. I'll report more later.
- Hard to say whether this evening was "better" or "worse" than this morning. She had so much difficulty moving her legs once she stood from the bed after her nap for transfer to the wheel chair that I, literally, took on her entire weight and "moved" her to and lowered her onto the chair. However, in the bathroom she was better able to stand, long enough for me to, both, remove her underwear before she sat on the toilet and pull up her underwear before she transferred to the chair. We decided to forgo any kind of slacks and opt for the lap blanket she received from the rehab facility upon "graduation". She also decided she didn't want to try transferring to the rocker, so she spent the evening in her wheelchair, which was fine with me.
At bedtime she had some difficulty with holding a standing position and transferring, but nothing out of the way for any evening when she might be very tired. - There was, as well, within the space of the few hours she was up in the evening a startling development of feet and leg edema, the likes of which I haven't seen on Mom since 9/2002 when she was first diagnosed with chronic anemia. I decided to administer 20 mg of furosemide before she went to bed. I usually give her 10 mg "just a whiff", as the visiting Hospice RN characterized it this afternoon, but I felt that the swiftness and extent of the edema required 20 mg.
This Day Is a Blur
Movement for 9/23/08:
- We had a construction company over here putting in grab bars. He arrived about 1000 and worked until a little before 1500, even though I had hoped that he would be out before 1400. I let him continue because Mom seemed thoroughly ensconced in sleep. I finally awoke her at 1500. She was clearly ready to arise by that time, but she was also iffy on her feet and obviously confused about our half grab-barred bathroom. One her primary supports was missing and this was difficult for her, although we managed. I decided, previous to awakening her, that it would be a good idea to make the entire day a wheelchair day. She didn't refuse. She had a fair amount of trouble with transfers, though; so much so that I changed out the pillow on her rocker to an "over-stuffed" one to make it easier for her to sit and stand. I'm not sure, but I think it's possible that her hemoglobin is dropping again. We're also having trouble with feet swelling. Some of this could be due to the acetaminophen, which I've cut out, as of today. Her arm is improving, though, slowly but surely.
Monday, September 22, 2008
Just One of those Days
Movement for 9/22/08:
- All "morning" Mom has been very iffy on her feet. I'm not sure why. Her right leg, in particular, has been buckling. She's been grabbing on to just about everything, including me, for security, so I decided that the entire day would be a wheelchair day, after her walk into the bathroom for her bath, which was very scary for me, not her. The grabbing business, though, created a huge problem. At one point, in the bathroom, she decided to grab onto the towel rack to hold herself up. Actually, it's been very sturdy and she occasionally uses it for this, but, today, as soon as she reached for it over my shoulder (I was holding her up in order to pull her underwear and slacks up) I sensed trouble. I harshly and quickly cautioned her to "Let go, it's not going to support you! Let go! Let go, I've got you!!!!" But, she didn't, and her Iron Woman grip snapped the thing out of the wall. So, now, we've got a home repair contractor coming tomorrow to replace it with a legitimate grab bar. I imagine it will take a couple of days to actually complete the job. As well, I discussed a few other security improvements in the bathroom and the company will scope the area out and see what they can do. I know, I know, this is something we should have done a long time ago, but, you know, everything was working well, has been working well for years the way it is, so we just didn't. Anyway, that's one good thing that came out of it. Otherwise, though, the incident scared both Mom and me and we've been very, very touchy with each other. I delivered a little "You Got to Listen to Me" sermon, something she doesn't often do, even when I'm sure she can hear me. She took offense at my suggestion that I know, better than she does, of what her body is capable. I don't blame her for taking offense, but I'm right about this. Whether she's moving or not, she always thinks that she's much more ambulatory and flexible and strong than she is. Well, except for her arms. She's right about the strength in her arms. But, when her legs aren't working, they aren't strong enough to support her by hanging on to things. Long, low, loud sigh. I have no idea what's in store for the rest of the day. I guess we'll see.
- She made it into the bathroom after her nap on her own two feet. She seemed fairly stable, too. I decided, though, that we should use the wheelchair out to the living room. We continued with wheeling for the rest of the night. She used the spit bowl for brushing her teeth, although she wasn't happy about it. She insisted she could stand at the sink for teeth brushing, but I didn't think it was a good idea. She also wasn't able to lift herself with her rocker arms enough for me to pull her slacks down over her butt for leg rubbing. She was, however, sober in her remembrance of the towel bar incident, so I was able to direct her regarding how to hold onto me for purchase while I reached behind her to pull her slacks down. We were able to do a leg rubdown. She's missed this. So have I. I suspect her slight lower leg edema will disappear shortly, now.
Sunday, September 21, 2008
Better Day, Incrementally
Movement for 9/21/08:
- So far, so good. It seems that walking into the bathroom in the morning and to the dinette table is a reestablished routine. I decided to add a little walking: I had her walk to the dinette steps (that lead into the living room) and descend the steps, since she usually does that using the table and banister for security. It was a little iffy for her, especially the steps, but she did it, then I wheeled her the very short distance from the steps to her rocker. I also decided, when she was ready for a nap, to wheel her to the foyer steps and have her ascend the steps and walk, with environmental and my support, into the bathroom. She did it, but it was clearly hard for her. She even said so. I assured her that we'd take it easy this evening; although I'm assuming I'll be able to get her to walk from her bedroom into the bathroom after her nap. From there on out it will be anybody's guess how much wheeling we do.
- Every day for three days, now, I've been having her try to raise her left arm in front of her, straight up, at least a couple of times; it's exercise but she doesn't think of it like this. She figures I'm taking a movement survey; and, I'm doing that, too. She can't get it very far. Today, though, she did better than yesterday. She complained, again, of forearm pain this afternoon. I figure that's from the effort she's trying to transfer from her bicep to her forearm and that's working her forearm out a bit more than usual. She tried to rise from her rocking chair on her own again today...didn't work. But, the fact that she's trying makes me think that she may recover this. We'll see. More later.
- Lots more movement than I expected, this evening, although it didn't happen until later. She did walk to the bathroom after she awoke from her nap, but opted for the wheelchair into the living room. However, when she headed in for the night, she insisted on trying to rise on her own from her rocker. This chair is the easiest for her to arise from on her own. Although it took some work and went slow, although she complained of pain in her legs once she'd turned toward the wheelchair and flopped into it, she did it. I congratulated her, more than once, "Job well done!" She turned her head coyly and gave me her best thin lipped ironic grin. This lead to a decision to stand at the sink to brush her teeth. I have to tell you, in the morning it's always been 50/50, whether she's going to brush her teeth at the sink or use the spit bowl. That's why I don't usually report on this. However, at night, when she's fully warmed up, her distaste for using the spit bowl is so intense that it's unusual for her to not want to stand at the sink...but, for a little over a week, now, she hasn't been wanting to try it. So, tonight, although I made sure I had a secure grab on the back of her paper underwear, in case she should waver, after brushing her teeth at the sink she announced, "Well, that's a relief!" Her left arm isn't bothering her nearly as much, although she still experiences twinges, sometimes sharp. She's aware of how "out of practice" her legs are in the walking department, especially since she had some muscular aching in her thighs this evening. But, overall, I believe she's revving up to rock, again.
Diffcult Day
Movement for 9/20/08:
- I'm writing this the day after, so I'm scouring my memory for what happened. I recall that she walked to the bathroom and the dinette table, both at her request. She did okay, although I was really concerned that she wasn't going to make it all the way to the table. She did, though. The rest of the day was wheeling, all the way. She winced a lot, talked about the pain in her bicep, and discovered a new pain in her forearm, although her shoulder didn't seem to be bothering her. I was anxious to try to get her moving and scolded her, lightly, I think, although she may have had a different impression, since she was clearly not up to much, yesterday, even though she was awake a lot (well, relatively speaking.
- In the evening she was clearly very tired. She walked to the bathroom after her nap but was wobbly, at best. At one point I asked her if she thought she could make it and she said she wasn't sure. I kept the wheelchair close, but she made it. The rest of the night, though, was wheeling. Several times during the day during transfers, I had to remind her that I was not going to pull her up, because that would hurt her arm more than if I didn't. She agreed that it would, but was not happy. She also resisted leaning waaaay over while sitting in order to transfer her weight to her legs before rising, even though I asked her repeatedly if it hurt her anyplace and she replied that it didn't. I think she was telling the whole truth. Late in the evening I had an extended conversation with her about the fact that she didn't injure her legs or back or hips, she injured her left arm. I told her I understood that she uses her arms for balance and security when she walks so, of course, some pain was going to be involved, to which she indignantly, surprisingly, responded, "Well, it's not that much."
"Okay," I said. "Then we need to get you on your feet, again. You're legs are losing their strength." They are.
She just glared at me.
It was a hard day for both of us.
