Probably Pneumonia x 3
    As I write this I'm about nine and a half hours into considering that my mother probably has pneumonia again. I just checked all my notes in my Pneumonia x 2 and Pneumonia x 3? posts, plus the two follow-up posts to that one and, all things considered, I'm sure that's what's happening. When the last one, her speech beginning to evidence "tongue thickening" although not at a really prominent point, yet, kicked in last night about an hour and a half before she retired it finally occurred to me that it might be pneumonia. As usual, this sneaked up on me. I've been noticing and treating (unsuccessfully) all her usual symptoms as separate, "unrelated" events, as I usually do. I'm beyond self-recrimination for not putting "things" together earlier, so, I'm just tsking, shaking my head, smiling a bit and wagging my finger at our familiar, ever camouflaged friend, partly in admiration of the wily devil that it is.
    Once Mom's speech started thickening and I put two and two together and figured out what is probably happening, I initiated our usual do-you-want-antibiotics conversation (I used the word "antibiotics", in this case, since I've learned she has a completely different concept of what "treatment" means and doesn't consider antibiotics "treatment" since it doesn't involve x-rays, needles, poking and prodding, etc.) if Hospice determines this is likely pneumonia and offers preemptive treatment. This time it was kind of a funny little conversation, partly because she was a bit hazy and her speech was a little hard to come by, partly because she was annoyed that I'd broken into our watching of one of our shared favorite movies, Love, Actually (we've delegated it to our Christmas Movie line-up), partly because she was so relaxed and feeling so good that she was indignant that I was talking about the possibility of ill-health. Here's pretty much how it went:
Mom (after I stopped the movie):  Why did you do that?!?
Me:  I think you might be developing pneumonia, Mom, and, before I call Hospice, I need to check with you on whether you want antibiotics if they offer them.
Mom (fairly snorting her denial, although she rarely snorts so it would be a misnomer to call it that):  Oh...cold...
Me:  Are you cold? (I thought, Hmmm...maybe I'd better take her temperature, I haven't taken it for awhile)
Mom:  Noooo...(disgust apparent)...ch...ch...
Me:   (I knew what she was trying to get out...when she's annoyed with me she calls me "child", not in a nice way) Child, Mom, I'm the child (I was grinning naughtily).
Mom:  That's right! Don't forget! (In order to get over her thick tongue she was starting to form very short sentences...which is good, at least I'll be able to understand her immediately.)
Me:  Are you saying you think it's just a cold?
Mom:  Yesss...jusss...t...
Me:  Well, you may be right. Last time that's all it was. But, you know, every time I suspect pneumonia, I have to ask...
Mom:  (back in control of her speech) Oh, I know! Ask!
Me:  (chuckling)If Hospice thinks it's pneumonia and they offer preemptive antibiotics...
Mom:  They won't.
Me:  Maybe not. But if they do...
Mom:  Yesss...yuh...sss...(she seems to trip over "s", in particular, I noted with interest, when her speech thickens)
Me:  So, that's a 'Yes', I want antibiotics, blah, blah, blah..."
Mom:  (practically disgusted, now) Oh, good...nuh...
Me:  (grinning) Excuse me, Miss, would that be 'good-NESS' or 'good-GOD'?
Mom:  (smirking) What do you think?!? (full speech command on that one)
Me:  Okay, so, would it be fair to say...
Mom rolled her eyes and sighed
Me:  That you consider your quality of life good enough so that you want to continue for awhile?
Mom:  (faster than a speeding bullet, and just as loud) Whaddoyouthink?!?!?!?
Me:  (laughing) I'm sorry...no, I'm not, I have to ask you, Mom. Okay. I've got it.
    Later in the evening, while we were in the bathroom for night-sleep-prep, her eyes brightened with excitement as she offered the following suggestion, haltingly, of course, but clearly enough so that I understood it: "Mother and Dad would be tickled pink if we dropped in on them Chris...ssss...," she waved her hand to indicate that I knew what she was trying to get out, "Eve."
    "Yes, they would! What a great idea! Let's plan on that!"
    She started to form a word, dropped it, which led me to believe the word was probably "yes", then said, "tomorrow..."
    "Tomorrow's not Christmas Eve, Mom..."
    She looked genuinely surprised.
    "That's in a little less than three weeks..."
    "Oh, my," she fairly shouted, "We'd better...plan..."
    "Yep. Let's plan on addressing your cold, first, though, then you'll have more energy for the visit."
    "Oh...yuh...
    "Yes, I believe, is the word you're looking for."
    She grinned.

    Anyway, I called Hospice at 0930 and they're in a meeting until 1030. Since it's not that urgent and Mom's sleeping peacefully I'm waiting out the time. For my own memory, here are the symptoms, approximate times that they've appeared and development, if applicable:

1. Unusually and intractably high Blood Glucose levels since 11/26/08;
2. Mild, fairly intractable fluid retention since 11/28/08 or so;
3. Daily reporting, sometimes twice to three times a day, since 11/30/08, of feeling "bad all over", although rarely any pain acknowledged, so she's been taking, willingly, sometimes asking for it, which is unusual for her, lots of acetaminophen and ibuprofen, on average 1,000 mg acetaminophen a day or 600 mg ibpurofen for day or a half-mix of the two; yesterday, though, after one in the morning, she refused any more, saying, "It doesn't seem to be helping."
4. Alarming intractable (meaning furosemide has helped little to not at all) feet, leg, belly and face swelling since 12/1/08;
5. Hospice RN reported "wheezing all over" throughout her lungs on 12/2/08;
6. Intermittent, laborious dry hacking for about a day and a half;
7. Casual report yesterday morning and last night of feeling like she has a cold;
8. Beginning of thick tongued speech since about midnight, last night;
9. Low grade (for Mom: 98.4; her normal temp runs around 97.6) fever at 0100 this morning, a half hour before she went to bed.

    Just about time to call Hospice. I think I'll peak in on Mom before I do. If her eyes are open I'll see what her report is on how she's feeling.
    Oh, yeah. We decorated our trees (we have two 32-inchers) yesterday, all afternoon and all evening, yesterday. Mom thinks we have too many decorations on them. However, I also got tree toppers for them this year and she's very pleased with those.
    Later. Of course.
- posted by Gail Rae @ 10:29   email  this post