Finish this sentence: "Everyone has to blow their nose after..."
    Funny the things one notices when one is plying the trade of Intense Needs Caregiver. The above question is one on which I've tested my mother almost daily for at least a month, at least once a day, usually twice. Mom knows the answer: "...sneezing and bowel movements." We've both learned that blowing one's nose during a sneezing fit usually stops the fit. As far as bowel movements go, somewhere in my life, probably while I've been my mother's companion and caregiver, I read, someplace, that when the body produces mucous to ease bowel elimination, it produces mucous from all its mucous membranes; it doesn't isolate the ones in the bowel, an easily observable bit of data.
    This information has become important, lately, because my mother's breathing is now so compromised that when she blows her nose she can't dally or she becomes critically breathless, whether or not she blows "around" the cannula, which I now encourage her to do (I then quickly clean the cannula after she's finished and replace it) or takes the cannula out (which she is wont to do and which I understand...it's hard to feel as though your nose is sufficiently blown clean when you've got plastic tubes in your nostrils). Either way, nose blowing is a dicey proposition, now, and always involves a couple minutes of breath recovery. I don't think she used to think twice about it. Now, though, she associates nose blowing with breathlessness and is reluctant to blow unless I remind her it's necessary. Why is it necessary? Because she often allows her nose become so stuffed with backed-up mucous and general nose shit that it blocks her breathing. I try not to bother her about it too much. If her breathing seems even and not labored I'll let a blowing session go, even if her voice sounds like her nasal passages are blocked. Sneezing or bowel movements, though, demand a good blow. So, for that matter, does awakening from night sleep.
    This week, which has been fairly critical for her breathing, I've established a mental tick to ask our Hospice RN, next week, if there are any available techniques for cleaning someone's nose that reduce the amount of breathlessness implied in this simple chore which most of us take so for granted we probably aren't even aware of it unless we have a cold. I try to keep all that nose stuff moist enough, with frequent applications of water soluble lubricant, so that it's easy to expel. I've tried applying it when she's sleeping but, well, imagine how you'd react if someone consistently fiddled with your nose while you were sleeping!
    Another concern seems to be developing. Two mornings in a row my mother has awakened before she's ready to arise, taken the cannula out of her nose, putting herself in respiratory distress, then called me frantically. We've managed to handle the situation before it works itself into yet another episode of incredible pain, but I'm concerned because it has been my habit to perform errands in the morning and in the late afternoon while she's sleeping. Luckily, I was home both of these two mornings, but, you know, what if I wasn't? It seems likely that my days of carefree errand wandering while she sleeps are coming to an end. I don't know why my mother is insisting on taking her cannula out, except that she's gone through phases of this before and I guess we're just going through another. It's previously never been a dangerous practice, though. It is, now.
    We tried using that easy-on-the-skin tape last night in the bathroom during night-sleep prep but she was not happy with it and I could imagine her ripping it off, with the cannula, in her sleep.
    I can, of course, call on Hospice volunteers, and probably will. I'll need to schedule them ahead, which means a bit more planning than is typical for me, but that's not a problem. In the meantime, tomorrow, for instance, when I plan to get my hair cut really early in the morning, soon after 0800, I'm going to retry a technique that has been successful before: Awakening her just before I go and, while she's still a little drowsy and her subconscious mind is pliable, telling her I'm leaving, where I'm going, how long I'll be gone and that I'll check on her as soon as I get back, so she is to stay in bed, asleep, until then. It's worked very well for us, before; so well that, on occasion, when I let her know the night before of errand plans for the next morning, she'll remind me to tell her just before I go. Now, of course, I'll add the dictate, "Don't touch your cannula," or some such thing. I'm hoping this technique remains viable.

    Yes, we're having a Thanksgiving meal today, even though we won't be celebrating with family until Saturday. Some (not sure how many) shoots off the Phoenix branch are coming up for a visit of a few hours on Saturday. In the meantime, I will finally be making the beef pot pie I've been threatening to make out of left over hunks of this last year's Hoisin Pot Roast for dinner tonight. In addition, my mother, while indulging in one of her favorite activities of browsing the holiday catalogs that arrive at our house, came up with two great ideas, the first associated with Thanksgiving, the second associated with Christmas:

• A little over a week ago during breakfast my mother began insistently drumming her finger on a page of one of the food catalogs, a page to which I'd peripherally noticed she continued to turn back. When I asked what had caught her interest she said, "Read this."
  I walked around the table and noticed she was attempting to drill a hole through a picture of a decadent, $45.00 Chocolate Mousse cake.
  "This is what we should have for Thanksgiving dessert," she announced.
  "I'm not sure I can make something like that, Mom, without miserable consequences."
  "No, I'm saying, we should order this."
  So, we did. It arrived, frozen with dry ice, yesterday. The frosting was a little cracked but after a couple of hours in the refrigerator I was able to repair it. It came with the shaved chocolate that decks the top in a small package. It arrived during her very late nap, yesterday. She had actually delayed her nap because she was hoping it would arrive and she could drool over it before napping, but she was able to do that afterward. It's the first time we've ordered something to eat for dinner through the mail. I hope it meets my mother's expectations. I think, Our Lady of Sweets (with a decided leaning toward all things chocolate) that she is, she will judge it as chocolate heaven. Wouldn't it be nice if there actually is a chocolate heaven for people like my mom? In the meantime, no harm in anticipating such a delight, certainly not anymore.
  Which reminds me: During our Hospice RN's last visit, when I brought up my slight concern over her lately rising BGs, which he dismissed (I was hoping he'd do this; she has never suffered any of the complications usually associated with diabetes and her BGs don't often move above her previously approved range) he mentioned that at some point "we'd" probably be dropping the glipizide. I didn't think fast enough to ask him why...although I thought about it afterward. I can't see that continuing her glipizide would be a problem, in fact I can actually anticipate how it might be a problem if we dropped it, but maybe he knows something I don't. Then again, maybe he's stuck in another "death rule", instead of observing the eccentric situation, as he was a while back over the issue of hydration.
• During the same Holiday Food Catalog Perusal session she stumbled across one that advertises catered holiday meals. "We should do this for Christmas," she said.
  I protested that I wasn't sure I'd feel comfortable paying for and hosting a phalanx of servers in French catering outfits serving our Christmas Dinner.
  "Can't we order the food without the servers?" she asked.
  Where have I been all these years (don't answer that)? Turns out, we can. So, Mom selected the type of ham she wants (the one that promises the sweetest glaze). Next, a couple of sides, a green bean casserole and au Gratin potatoes, both of which surprised me, considering that she has, at various times throughout our companionship, waxed eloquent on how much she hates green beans and potatoes. "But, they have cheese in them," she argued, another of my mother's weaknesses. Sure enough, the green bean casserole is seasoned with, among other things, Parmesan and, of course, well, you probably know all about au Gratin potatoes. I've occasionally passed these off on my mother by making mine with added ham or sausage and variety of seasonings and sauteed vegetables. Lastly, she selected a dessert of apples baked in pastry and smothered with a cinnamon-caramel sauce. "We'll need whipped cream for those," she informed me. The whole production is a bit more pricey than cooking the raw ingredients, but we can afford it and it sounds like fun. We'll also have gobs of food left over, more than usual, so I'm reissuing my holiday visiting invitation this year to all relatives and friends who dare show up, no matter why, no matter when, no matter who.

    Hmmm...I started this post, the time label tells me, at 1249 today. Mom awoke earlier than I expected at 1330, so I left it until now, 1907. Although she was not happy with the weather again today and spent the first part of her day "under" it, she was alert, ate well, watched half of My Fair Lady while supervising my constructing of the beef pot pie and trying to get me to bake it immediately so that she could try some before she went down for a nap. Right now, all cats and Honorary Cats (my mother is the Honorary; our cats have dubbed her this since discovering that she has a talent for sleep) are napping and I can finish off this post and relax for a bit.
    Oh, did I mention? I've link-checked all sections. I was thorough, but I'm assuming I missed a few here and there. However, all search engines connected to the various sites (which depend upon accurate links) are up and running. I'll be indexing the three I write in most, including this one, every couple of days. My final project consists of fixing all the links in the test results section, adding the final tests from her hospital and rehab stays (I still have to request from the hospital the final lung CT, from which my mother's lung cancer was diagnosed but, for some wonderful reason, I'm no longer rabid about obtaining copies of tests...at this stage they are only of peripheral interest) and moving everything over to the domain. That may take awhile. In the meantime, all tests are still viewable on their old server...just don't use the links sections to the left on the pages.
    Maybe I'll catch up on some of the news critique programs I recorded last week. Maybe I'll do some reading. Maybe I'll just "chill". Oh, yeah, that reminds me...but, you know, I think I'll cover that...
    ...later.
- posted by Gail Rae @ 19:17   email  this post