Twenty Breaths per Minute and Holding
    That's right. I checked her while she was sleeping before I ran my errand and when I returned. The same both times. We are also now the proud lessees of a "high flow" concentrator with all it's high flow paraphernalia, including a high flow cannula, a high flow delivery tube (which comes with the built in cannula), and a high flow humidifier attachment (which partially explains why the humidifier attached to the other tank was spitting; the other part of the explanation is that I overfilled the bottle out of ignorance). I find it interesting that, for the purposes of equipment, 6/lpm is considered "high flow", even though it's cited officially as being the upper limit of "low flow".
    She just awoke, but not yet for the day. I think she may just have been repositioning herself and started to cough. I told her I had planned to let her go until "four or four-thirty". She recommended that I wait until four-thirty. I agreed, since 3 hours had been cut out of her usual night sleep period and she's had "a hectic morning".
    "I sure did, didn't I!?!" she said. "What would you do for excitement if I wasn't around?"
    The morphine may be wearing off, I'm not sure, but she reported that she isn't having any difficulty breathing, although she sounds like she has a cold, exactly the way she sounded this morning, her voice blocked by the lack of nasal resonance. She seemed a little disoriented, but that's common when she awakens and wants to go back to sleep. It's also common when she's not feeling great and she's probably still fighting a cold or something.
    From something one of the three Hospice RN's with whom I consulted today said, I gather they're betting that all of this is strictly "cancer related". My attitude is, considering that Mom has lung cancer, everything in regard to her health is, now, "cancer related". She didn't used to get colds, for instance; she does, now, regularly. Still, though, I make a distinction between direct relationships to cancer, such as, for instance, the fact that all air flow, now, appears to be blocked in her right lung per the visiting RNs assessment, and indirect relationships to her cancer, such as the difference between how she feels and operates when she has no cold and when she has a cold. I figure, if you've got lung cancer and a cold, it's a good idea to consider treating the cold along with the cancer, instead of treating the cold as cancer.
    I want to mention in regard to Mom's high BGs of late: When I ran through Mom's numbers for the visiting RN for the last week plus, to the point where her BGs were normal (for Mom), the RN said that, in the presence of infection, she usually sees BGs much higher than that. She confirmed my observation of the recalcitrance of high BGs related to infection, though, when I told her of the recent day when both numbers were in the low 200s, the morning number having been taken a good 15 hours after her last meal in which refined carbohydrates were practically non-existent and I'd already stopped the nightly prune juice by a day or so; on that day I also fed her four 10 mg doses of glipzide, knowing that, officially, more than 20 mg per day is reported to have no effect but, in my mother's case, 30 mgs does have an enhanced effect but an extra 10, to 40, usually doesn't seem to make a difference. I'm not sure whether my mother's profile would, in the presence of infection, necessarily boost her BGs higher than they already are. During her first bout of pneumonia on Hospice, when I was unaware that the presence of infection affects BGs (I know, how have I been tending to my mother's sweet blood for so long without knowing this...apparently it's fairly common knowledge...oh well, the lack of it didn't hurt either of us), the on call RN asked about her BGs and said that the high run at that time, which rarely hit 200 and ran in the 170s in the morning and the high 180s or low 190s at night, qualified as BGs probably affected by infection. I guess a lot of health calls are seat of the pants and depend on who's seat is in the pants. This doesn't surprise me, not with my experience as Mom's medical advocate. It's not easy to negotiate this wavering of information but, you know, overall, this is why Medicine is considered an art as well as a science. I not only have been living with this dictum, I can continue to live with it. So, it appears, can Mom, at least for the time being.
    As I was running the errand, which turned out to be for naught, I reflected on the fact that I've been posting double-time lately. I know this is happening because there is so much to report that I want to catalog in my online memory. During times like these when things are in quick flux posting helps settle me down as I review, too. I realized, though, during my reflection, that despite the fact that I've been heard to "say", on many occasions, that I primarily write here for myself, I write for others, as well. I can't tell you how many times, over the last several years of caregiving, I would have loved to have had access to a rambling, searchable "place" that described an actual person with an observable character going through the moments and the thoughts and the actions of situations similar to the ones I've confronted. "Watching" someone step, and step again, and misstep, and catch the misstep and back up, then go forward to the next step, listening to their monologues and dialogues, internal and external, as they negotiated their way through another event, or, even, the fallowing fields between events, would have been very helpful for me. Since I couldn't find that "out there", well, I guess I decided to create it.
    So that's my full excuse for doing this. Not that I need one. But, you know, it just struck me, today...
    Maybe I can rest my eyes for about a half hour before I pull Mom into the awake part of her day.
    Later.
- posted by Gail Rae @ 15:17   email  this post