I'd forgotten how intense wheel chair days are.
    I also forgot, until after Mom's bath, that wheel chair days are possible in this house. When my mother was laid up with her back injury in the fall and winter of 2003, wheel chair transport through the house and its attendant life style were normal. That episode is so long time gone, though, that I spent yesterday being brutally reminded how demanding the life style is.
    As is typical, the day after her fall was worse than the evening of the fall. She pulled a muscle in her left hip and it "grabbed" (her word) every time she attempted to move in a way that demanded a turn to either side. She reported that the grabbing wasn't terribly painful (four on her personal pain endurance scale of one to ten) but caused her to falter dangerously, which was evident from the time she arose from bed and we discovered transport from the bedroom to the bathroom (a distance of about 25 feet) would be safely accomplished only if she leaned on me, placed her feet directly in front of mine and walked forward as I walked backward, embracing her in a Jaws of Life grip.
    As we bathed her, though, she insisted on standing through torso bathing, even though I had mentally devised a method to accomplish this with little standing and moving. She did well through the procedure, but when we were finished and her body was dressed from the waist down, her hip pulled again when she moved to sit back on the toilet seat. This signaled to me that it would seem prudent to figure out a better way to get her from the bathroom to the dinette, a distance twice that of bedroom to bathroom.
    Knowing that negotiating the two steps into the living room would not be an option for at least all of yesterday, I began assessing and arranging the house and our available mobility tools in order to figure out how to live our life on one level. I figured out a method which involved a short supported walkering across the carpeted area into the hall, which I thought she's probably be able to negotiate, then, remembering an incident a couple of years ago during a flu-shot-orama at a local grocery store in which one of the men in line showed me that our style of walker can be pulled or pushed easily across hard flooring while the user is sitting on the seat, decided I'd have her sit on the walker at the entrance to the kitchen and pull her to the dinette table. It wasn't until I was finished and satisfied with setting up this temporary living arrangement and headed into the foyer to retrieve a new canister of oxygen that I noticed the wheel chair, which sits in the foyer in front of the oxygen canisters in order to keep them from falling when the cats play in that area. Using it, while promising a bit more ease through the day, required a completely different arrangement.
    Wasn't as easy as it looked, though, although I'm sure it was easier than my first idea. By the end of our day all those wheelchair maneuvering muscles that haven't been used in awhile were registering extremely unpleasant surprise...not pain, really, but a level of tension to which I haven't been used for awhile.
    I was also reminded that "wheel chair days", for Mom, equal "Queen for a Day or Days" episodes. She relaxed (for which I am grateful, in a roundabout way) so completely that she initiated a round of "my slave will do it" behavior: Dropping napkins, Kleenexes, even eating utensils (thank the gods she didn't transfer this behavior to plates) on the floor when she was done with them for me to retrieve and dispose; throwing her soiled paper underwear just any old where in the bathroom instead of depositing them in the trash can which sits immediately and conveniently to the side of the toilet; depending on me to straighten and lift her legs in order to get underwear, knee bandages and clothes on, despite the fact that she continually reported no pain or difficultly when I badgered her to do it herself; etc. By evening, after dinner, I was so tired and disgusted and so very aware that none of it was necessary that I had a minor explosion: "Two rules," I announced, after the third throw-the-underwear incident, "Although all evidence appears to the contrary, I am not a slave laborer so you are not to treat me as one, and, don't take me for granted."
    Whoops! That was an eye-opener! She and I understand each other well enough and this mutual understanding is flexible enough so that we both silently acknowledged that no apologies were necessary, but she knew exactly to what behavior I was referring and immediately changed her Methodology of Injury.
    I had her on an extra strength Tylenol course all day. I decided against aspirin and ibuprofen because I figured she'd need analgesics all day long. I was right, although she took fewer analgesics than I thought would be necessary. I'd timed their delivery so that the last dose would be delivered just before bed with toast, but she refused both the toast and the pills, reporting, after a sitting down, standing up, transferring from chair-to-toilet-to-chair in the bathroom episode about an hour before she went to bed, that she didn't think further Tylenol was necessary. I almost always honor her preference on the matter of analgesics. They worked well throughout the day and by bedtime, although she was tired and physically iffy enough so that I felt it necessary to devise a method whereby she could brush her teeth while sitting on the toilet, when she arose to go to the bathroom in the middle of her night sleep she insisted on not using the wheel chair and did just fine, without reports of pain or grabbing (I asked, almost obsessively, until she fairly shouted, "I'll let you know if I hurt or need help!").
    She was also a bit hazy after an entire day of inactivity and napping, but I'm used to this and don't attribute to it any need for concern.
    I was concerned, however, that my unexpected exhaustion from the day would mean I might not respond to the noises she makes when she arises in the middle of the night to go to the bathroom, so I pulled my futon part way into the hall. As it turns out, I was so primed for possible bathroom visits (or anything else) that, despite dropping into something similar to a drugged sleep as soon as my head hit the pillow, I heard her shift to a sitting position in her bed when it was time for a trip to the bathroom and was at her side before she'd gathered the wherewithal to stand up. I was, however, so tired that when she tried to initiate one of our typical visit-and-chat sessions in the middle of the night, I rebuffed her. "Mom," I said, "I'm too tired to visit. I need to go back to bed immediately. So do you." She accepted this.
    Her self-set schedule dictated another later than usual bedtime, and, as well, she heals so well in sleep mode, so my intention has been to allow her to sleep until 1400, today. However, it is 1330 as I polish this off, now, and I'm hearing her cough, so, hold on a minute, I'll check in on her. She might be ready to "rise up oh lamb of god", which is a phrase I use to tease her into standing when time is of the essence, I can tell her muscles are ready, but her mind is resisting the thought.
    Hold on while I'll check on her.
    Ah! She's changed her position and quickly settled back into sleep...so I've got some minutes to reset the house for another wheel chair day. After wheel chair days, I always set the house back to normal, in case she arises and wanders through the house without my knowledge. This has happened so few times it would seem unlikely on any particular night, but, you never know. I want to make sure that if she wanders and I don't immediately realize she's up, the furniture arrangement will not hold surprises for her.
    Whether the entire day will be a wheel chair day remains to be seen. If she seems determined to move a bit more, today, I'll not stand in her way. However, I'll continue to keep her at one floor level; don't think we'll tempt fate with any stair steps, today. Thus, even if she is more mobile than yesterday, in order to keep things easy and flexible for any possibility, we'll continue to use the wheel chair as Her Chair. This also allows for the arrangement that is most advantageous for TV viewing from the dinette and, as well, the wheel chair is a great substitute for her rocker, as it naturally assists her in sitting upright with feet on the floor, rather than slouched over some other means of support with her feet kicked back behind her.
    I have to admit, when this "seemingly emergent blip" first happened, my alarm kicked in and triggered my usual out-of-the-ordinary thoughts: "Uh oh, we're on the downhill slope, here we go!" But, once again, instead of slipping, she's maintaining, with some effort, to be sure, but without indications of serious consequences. She's a trooper, this one.
    This episode has provoked me to reconsider looking for a local PCP for her. Yesterday I plundered some acquaintances for a couple more names and recommendations and intend to restart the process this week. Wish me luck.
    I'm ending this post between chores. The house is set. Mom is bringing herself to an upright position on the bed and cooing to the cats, who always attend her at rising and bed time.
    Time for me to officially skedaddle.
    Later.
- posted by Gail Rae @ 14:10   email  this post