Did I mention that the first time I contacted our new hematologist...
...to ask whether he'd be willing to consult with an out of town physician the man answered his own office phone? When was the last time you encountered a doctor who answered his own office phone? This suggested to me:

• He isn't afraid of his practice.
• He isn't afraid of his patients.
• He is, rather, engaged in his work and confident enough in his abilities and performance to step up to whatever the day, and his phone, may bring into his life.

    Today Mom, and I, met with this doctor. Neither of us could be more pleased. To begin with, his office is highly accessible to those with mobility problems. As Mom and I walkered/walked into the office, before we had even decided where in the waiting room to sit, his front office person asked if I was "Gail". Although I'd talked with her maybe four times in the last two weeks, I hadn't divulged a lot of information about either Mom or me. I can only suppose that she may have browsed the records Mom's Mesa PCP's office faxed through last week and/or recognized my voice as I coached Mom through the door and across the lobby.
    While Mom and I filled out forms and I handed over the documents I'd copied for their files (the usual legal ones that all medical offices appreciate even if they forget to ask for them), the clients seated on either side of Mom and me initiated conversations about how great their experiences with these two (it's a partnership) doctors are. Astonishing!
    Since I had not pre-scouted the area, I'd given us waaay more time than we needed to make our appointment on time. Despite the high activity of the office and the coming and going of patients, we were ushered into an examination room early and apologies were offered for keeping us waiting! Yeow!
    Our hematologist was not only thorough in his questioning, he listened, asked further questions about what I offered, commented on what he noticed in her most recent blood tests and conducted, doctor to patient, the usual survey, the one patients normally fill out on paper asking for physical details like height, weight, family history of disease and death and medication sensitivies, filling in Mom's and my responses himself. He allowed us the time I needed to shout certain questions directly into her ear so that she could have the dignity of answering on her own behalf. He allowed her to answer some of them wrong and looked to me for correction. He answered my questions about what his understanding was of what her PCP wanted from him. He is the first medical professional in three years who acknowledged that her kidney functions, however "fine" her electrolytes looked, were not "fine", as three other doctors have pronounced them.
    Another medical professional, I believe she may have been the other doctor at the clinic, observed the way my mother uses the walker, tried to coax her (as I do at least 50 times a day) to place herself closer to the walker and walk straighter, then, when it was obvious that my mother simply wasn't going to comply, at least not fully, sympathized with me, asked if Mom had "a bad heart", which I confirmed since, at the very least, she has an overburdened, tired heart, then went on to explain not only that my mother's walkering behavior was typical of people harboring my mother's physical challenges, but that she had exactly the same experience with her mother as I'm having with mine, also showered her mother with constant coaching and was similarly unsuccessful.
    Not only was I well pleased with our visit, today, so was my mother. She's asked me several times to remind her of the doctor's name and, with each reminder, has said, "I like him." She also, surprisingly, absorbed an unusual amount of the conversation that went on around her. We are slated to have her blood drawn for several tests tomorrow at the hospital lab. She remembers that the doctor ordered these tests as a prelude to a transfusion. I've confirmed this for her a couple of times, tonight, when she's brought it up, adding that it's not an absolute certainty that she'll be receiving a transfusion on Friday, but highly probable. My mother's response has been, "I don't know about that. I think he mentioned that I will have a transfusion." Although he actually didn't, I have to concede that my mother was so finely tuned into what he was saying that she may have picked up on some undercurrent that I didn't.
    Additionally, she isn't fighting the possibility of this transfusion. I think this is because she not only likes this doctor but trusts him implicitly, for which I am ever grateful. It is not that she doesn't have similar feelings about her PCP; she does. But, from her perspective, he has never been directly involved in her transfusions. She's never been in on the conversations about them. With this doctor, she was there for the whole thing, heard him utter the words, was able to follow his conversation about her blood and her anemia...and, however little or much she may actually have understood, his effort to involve her in the conversation allowed her to connect him directly with the state of her health and trust his decisions.
    Throughout the evening she has been resistant to the idea of arising "early", yet again, tomorrow, without breakfast (some of the tests require fasting), so we've had a few conversations in which I've slowly but surely planted the idea that we need to cooperate with the doctor as much as we can. He'd like the results in the afternoon so he can make a decision about a transfusion and, if necessary, set it for Friday. Thus, little by little, I've coaxed her into an awakening time, tomorrow morning, at 9:00 am, working down from her idea of a 10:30 am rising. It may seem silly for me to work through this with her, especially since her dementia will likely sap all this information from her conscious mind and she'll be surprised when I bend over her "good" ear tomorrow morning and say, "Good Morning Mary Sunshine." However, my experience tells me that something of her subconscious mind retains these evening discussions and, even though I'll have to remind her what our plans are for the day that demand an early rising, she is much easier to get out of bed when we've worked out the details the evening before and she's agreed to them.
    Too, I offered a small bribe. I told her that, after the blood draw, instead of going home for breakfast we could scout out the food available in the hospital cafeteria. She likes cafeteria settings. Besides, during her last blood draw I tried the cafeteria's salad bar. It was more than passable. It will be like going out to eat for her. We haven't done that in a long, long time.
    I expect the next few days to be hectic. I'm rather hoping (and sure) that she will be receiving a transfusion on Friday. It will be nice to have the evening to prepare for it. These are lengthy, boring procedures. Knowing in advance that one is coming up, we can take a stash of reading material, money for cafeteria intervention when necessary and, maybe, even take along Sorry and play a few rounds. I expect, as well, there will be time for a nap for her if she decides she'd like one. We'll definitely take along a comfortable pillow.
    Transfusion or no, some of the tests the hematologist has ordered are for the purpose of exploring the possibility of epo shots for Mom. I'm relieved about this. I know there are risks involved, some of them vaguely suggested in fairly recent reports. My feeling, though, is that the woman made it to 90 and in tremendous spirits. It's all icing on the cake from here. Being 90, for my mother, is a day-to-day risk in itself, even though she doesn't consider it so (and, I have to concede, her refusal to acknowledge the risks probably lowers them). If epo shots here and there can keep her anemia at bay enough so that she has more energy, is slightly less mentally wonky (what I often call "stupid-silly", a condition that distinguishes her episodes of low hemoglobin) and she doesn't have to endure really frequent transfusions, well, damn, let's sweeten up that icing.
    Later.
- posted by Gail Rae @ 22:58   email  this post