Apologia for these journals:
They are not about taking care of a relative with moderate to severe Alzheimer's/senile dementia.
For an explanation of what these journals are about, click the link above.
For internet sources that are about caring for relatives with moderate to severe
Alzheimer's/senile dementia, click through the Honorable Alzheimer's Blogs in my
links section to the right.
As the day has progressed...
...I've been adding information to the immediately previous post, as I remember this or that piece of conversation or information. I hope I don't drive those of you who subscribe through RSS crazy. I just want to be especially meticulous about reporting this episode, for myself, chiefly, as I imagine we have more episodes in our future, however short or long that future is.
As I reported over at Life After Death Sentencing for today, Mom's restless night is dictating a day a bit less energetic than yesterday. She forced herself to stay up for the entire showing of Close Encounters of the Third Kind on TCM. Well, I don't think she had to force herself. The movie fascinates her. It's one she never remembers seeing. Today, her comment was that the movie is "mysterious". "I'm not sure where this is going," she mentioned.
I'd already noticed the tiredness pulling at her lower lids, swelling her eyes. "Are you bored?" I asked. "I taped this, so if you want to come back to it, it's okay."
"Oh, goodness, no! I want to see if I can figure out what's happening!" She stayed with it all the way through.
She's sleeping, now, a much more restful sleep, I can tell by the monitor, than happened last night. It occurred to me that last night was analogous to the breathing crisis she had in the hospital late at night after the first day of her treatment for pneumonia: The anxiety about which I was contacted by the nurse in the middle of the night when Mom was having a breathing crisis and calling for me. The nurse was seeking permission to administer Ativan or Xanax or morphine, all of which I vetoed in favor of me coming in and holding Mom's hand, sleeping right by her side and reassuring her, which performed all the tricks that the medications were supposed to have performed. The difference, last night, was that Mom was in her own home, in her own bed, The Little Girl was sleeping with her, and Mom knew that I was near and listening (she is quite impressed with the monitor and has not forgotten that I listen to her when she's sleeping, so I keep her updated, after each sleeping session, on what I hear) because I went into her a few times during the night, provoked by what I was hearing on the monitor, to see how she was doing, help her change position for easier breathing and to reassure myself and her that "everything is fine", so there was no anxiety involved in her crisis; just restlessness.
Funny thing, too, about the monitor. Since I've insisted on having it on and close every time she's sleeping, I've become acclimated, very quickly, to Mom's breathing moods. I was hoping this would happen. Although we've had it less than a week, I find I can fall asleep easily, knowing that my brain will register anything that sounds odd and alert me to awaken and check on her. I can even tell when she's merely coughing in her sleep versus when she's coughing because she's arising. I hear the oxygen compressor cycling, too, and sometimes I here her talking to The Little Girl. This morning I heard what I thought was was this, so I peaked in. She was fast asleep, though, and I realized, with surprise, that she was talking in her sleep. Unfortunately, the sound quality of the monitor wasn't such that I could make out what she said. I've never known her to talk in her sleep, though. Possibly, it's something that she does only when she's restless.
Tonight we're planning pizza night and a showing of The Sting in honor of Paul Newman. Mom was as saddened as I by the announcement of his death. It was her idea to honor him tonight. Although we only have one of his movies in our collection, she and I have seen several. I'm actually not sure why we don't have more of his work. Cool Hand Luke is one of my all time favorites. I also love The Verdict and have a soft spot in my heart for Hud, as it was recommended to me soon after it was originally released by a then best friend of mine. I never understood why she recommended it, as she also recommended Shane and the two are quite different.
So, anyway, it looks like it's going to be a laid back weekend...as though we don't always have laid back weekends here!
Pneumonia X 2
I'm going to assume you haven't been keeping up with the Life After Death and Dailies journals. Even if you have, you'd be only obliquely aware of what's been going on over the last few days, as I haven't been posting; I've been too busy caring for my mother. I up-to-dated both journals up this morning, but only bits of pieces of the story of our last few days exists in them, so I'll weave together those threads with others here:
- Since the beginning of this week certain infirmities, not uncommon but usually signifying, when appearing together, the advent of an acute episode of "something-'er-other", have developed. In order of appearance:
- Falling twice in the last two weeks, especially considering that my mother doesn't have a history of frequent falling.
- Feet and lower leg edema, which developed slowly but which didn't abate overnight after late night leg rub downs.
- A heightening weakness, especially regarding Mom's ability to use her legs and "mobilize", that finally reached a level that caused transfers to be so difficult that I was, sometimes, taking holding of her as soon as she arose and lifting and swinging her from chair to chair. This development also caused much concern regarding such activities as groin bathing (which we managed to accomplish with some difficulty).
- Wednesday evening over a period of three hours my mother's feet and legs swelled so quickly and alarmingly that I decided to administer furosemide in what for my mother is a "double dose", 20 mg, before she retired. Although this helped the feet and leg edema abate somewhat, it didn't even touch her continued and escalating weakness.
- Late Thursday evening she began to exhibit what I call "tongue thickening", in which her speech sounds as though her tongue is swelling, although she has no trouble swallowing, which means that it isn't actually thickening, it is, instead, a neurological development.
- Once all these symptoms were securely in place, Thursday midafternoon, except for the tongue thickening, my concern had heightened to the point that I thought it would be a good idea to call Hospice and speak to a nurse in order to outline the developments as what I called a "reference point", in case further developments required later action. The RN to whom I spoke while the office was open was thorough and understanding. She understood that, at that point, I didn't think action needed to be taken but, as I told her, I wanted to make sure that Hospice was aware of what was going on, primarily so we could avoid an ER visit if my mother's condition worsened. At this point I suspected that it would worsen but not for a day or more. This would have taken us into the weekend and I wanted to make sure that on call people would have a clear history of what was happening, just in case. At this point, after discussion, the Hospice Nurse asked me to take her temperature and call back if it was over 99.0 (F). At 1515 it was 98.9, which is high for my mother, but it wasn't over 99.0 so I didn't call back. I suspected a hemoglobin plunge, although nothing in particular indicated this and I was open to other possibilities, as well.
- Before she went down for her nap at 1600 (early on this day but she was so tired she couldn't keep her eyes open) I noticed that her speech was becoming difficult, as though her tongue was thickening. This concerned me, as this one symptom, in particular, was exclusive to her development of pneumonia in May. The Hospice office was not yet closed, so I called to report this at 1615. The RN to whom I had previously spoken was out on an "eval" but the receptionist, who is familiar with us, promised to pass on this information, as well as the exact measurement of the "below 99.0" temperature.
- At 1708 I received a call from the Hospice Nurse on call, the same nurse who had taken our initial intake evaluation back on 5/21/08. We had a long conversation about what might be happening with my mother, considering in detail her health history, which this nurse remembered taking. My chief concerns were:
- Are any of these developments "typical" of lung cancer decline?
- Either way, in light of Mom's lung cancer, I was confused about whether and how to treat these symptoms and the possible underlying causes;
- I was also confused about, and frightened of, the possibility that tests would be required and a hospital visit might be arranged...I absolutely want to avoid all possible hospital visits, from this point on; they are much too traumatic for her, now, and hospital procedure design no longer suits my mother: It is either too dramatic or too slow or both (as in the case of her last visit).
- During the discussion, it became apparent that the tongue thickening seemed to indicate that the problem was probably pneumonia. At this point the conversation centered on whether to treat. On the one hand, as the nurse pointed out, considering my mother's underlying diagnosis of lung cancer, this will most likely not be the last episode of pneumonia, as lung cancer creates a particularly inviting lung environment for pneumonia: Compromised lungs that collect and hold moisture at an ideal temperature for the development of bacteria. This was, as the nurse highlighted, a rather typical trajectory for lung cancer. My mother's first "lung cancer" pneumonial episode was in May. It's been four months since then. As the cancer develops, the periods between pneumonial episodes, and/or acute health crises, decrease, dramatically. In a theoretical case she cited that, say, the first repeat might happen at three months; the second at three weeks; the third at three days. On the other hand, keeping in mind, as I pointed out, that pneumonia can be a kind way to avoid the inevitably ugly death of fully developed lung cancer, was this the "no treat" episode?
- The Hospice RN was incredibly helpful and compassionate in this regard. We talked about my mother's overall health and attitude at this point: Her appetite, for instance, a big factor in decisions of this kind, remains excellent. Her spirit and will remain strong. She was, during this episode of increasing weakness, frustrated and angry at what was happening and continued trying to use her legs and feet, even when they were uncooperative. As well, and finally, I said to the RN, "I guess what I'm looking for is some evidence that my mother is resigned to what's happening to her right now. She isn't." Although we continued discussing this for a bit, prompted by my question about whether there are people who remain unresigned right up to the end (which there are, the RN confirmed; it is impossible, at this point, she said, to know whether this will be my mother's attitude...it's impossible for me to know this, as well...I can't even guess) it was this particular aspect of this particular development of crisis-related symptoms that tipped the scale toward a decision to treat.
- At this point I was given two options: The first was blood tests and a chest x-ray on Friday to see if pneumonia was showing. The nurse asked about the x-ray upon which Mom's May pneumonia was diagnosed. Although I don't have a copy of it, I remember looking at it and noticing that it said, "interstitial fluid build-up". As well, she asked about the time frame of the chest x-ray in connection with the beginning of treatment (the initiation of the IV antibiotics Levafloxin and Ciprofloxin), which was less than 24 hours. She asked about coughing, which my mother had not been doing other than minimal coughing in the morning (sometimes not even this much). We both noted that lack of coughing had been present during her last pneumonial episode. As well, we discussed White Blood Cell count. I reported that, to the best of my knowledge, my mother's WBC had not veered out of the "normal" range during the last episode and, in fact, historically, doesn't move out of the "normal" range, no matter what is going on with my mother. The nurse got a kick out of this (as well as other asides about my mother when she is acutely ill); she said something about how my mother has a wily tendency to "hide" indicators. This is more than the truth, it is my mother's body's MO. The second option, she said, was "preemptive treatment", in which an oral antibiotic would be ordered to begin that night and we'd continue on that course and see if some, if not all, of the symptoms cleared. After a bit more discussion, I opted for this. She called to clear it with Mom's Hospice Physician.
- When the Hospice RN called again to tell me that the physician had okayed preemptive treatment with antibiotics she wanted to confirm that I was familiar with possible side effects of Levaquin, considering my mother's extraordinary iron consumption (her recommendation regarding time lapses between doses of iron and Levaquin are that Levaquin should be administered two hours before or four hours after iron supplementation; although this is in disagreement with "the literature" on Levaquin, including the insert from the pharmacy, my experience, including past advice from Mom's former PCP, tells me that it would be best to follow the RN's recommendation) and her diabetes, she mentioned something I didn't know about diabetes and infections. "In the presence of infection," she said, blood glucose is likely to go crazy, either registering higher or lower than normal.
"That's interesting," I said. "Over the last week or so her blood glucose numbers have been higher than normal." I cited number ranges, both "normal" and for the last week, which, upon examination, appeared to be registering 30 to 70 points above normal. The RN felt that this was a confirmation that infection was present. The RN also told me that she'd questioned Mom's Hospice Physician about what I might expect regarding time of recovery. I was surprised, as I hadn't asked, but pleased that she'd wondered on my behalf. The doctor, she reported, "...could be months." In other words, I reflected, considering Mom's current health profile, she may be pneumonia-bound for the rest of her life. I'm neither surprised nor concerned. We'll just take it as it comes.
- I took a moment, in our first conversation, to ask the Hospice RN about whether a flu shot, this season, would be advisable. I've been questioning this in my mind, considering my mother's noticeably declining lung condition. I mean, is it wise to risk a flu shot if she might react to it and get the flu? I consider this, now, a very real possibility, even though I didn't a year ago. Things are different, now.
The RN mentioned exactly the same concerns that I had been contemplating. I'll run this issue by Mom's usual RN, but, at this point, I am as likely to opt out of the flu shot for her as I am to opt in for it. I will be getting mine; just so I'll be a bit safer for my mother to be around, assuming that the shot isn't as ineffective as last year's was.
Along this line, the RN started to mention something about the pneumonia vaccine. I mentioned that my mother had completed "the series" and that the nurse who administered her last pneumonia shot, I think it was in 2007 (I'd have to check) said that she was protected "for the rest of her life", which I find a bit ironic, now. The RN said she thought the series actually lasted for three to five years. Whatever, I thought. "Little did she know," I joked to the RN, "that the stretch of Mom's life was already being dictated by lung cancer and she, indeed, would not need the shot again for the rest of her life." So, you know, as I look back on the pneumonia series, now, I see that its effectiveness can be overwhelmed by other conditions. This doesn't surprise me, either. Lung cancer is one of the Big Guns. I don't imagine much gets past its influence when one allows it to have its way, which we are doing.
- At 1825 I was on my way to the pharmacy picking up the antibiotics.
- Mom received her first dose promptly at 2000, when I awoke her from her nap. At this point she was still noticeably weak and cranky about being weak. She was also voraciously hungry and remembered my promise that she could have a Carl's Jr. Guacamole Bacon Burger and onion rings for supper. By the time she went to bed that night she was feeling startlingly better (I didn't think antibiotics worked this fast) and looked better, as well. The paleness, which had been encroaching from the side of her face, had disappeared. She stayed up until 0100, feeling good. The tongue thickness hadn't subsided, nor had the leg swelling or the difficulty using her legs, but she even reported that she felt better. She attributed this to the hamburger and onion rings.
- Yesterday morning the tongue thickness had disappeared. Her feet were looking better, although not yet completely normal. She awoke on her own before I had planned to awaken her. I was going to let her go until 1330, but she was up at 1300, sitting on the edge of her bed, her glasses on. She was planning on walking to the bathroom, as is her usual habit. I discouraged this but took note that her transfers were perfect and energetic throughout the day. Before napping, before rubbing her legs down in the evening and before heading into the bathroom to prepare for bed she was able, with ease and without drama, to raise herself from her rocking chair with her arms on the armrests. She hasn't been able to do this for the entire week.
- Last night after bedtime through this morning has been a bit of a challenge. Bless that "nursing" monitor, I heard it all! I noted that it took her breathing a long time to settle into a regular rhythm, last night,which meant that she was having trouble adjusting herself into a comfortable position; the monitor confirmed this. She awoke coughing and blowing at 0845. When I dashed into her bedroom, the wasn't ready to "get up for the day", but she wanted to go to the bathroom before going back to bed. I took advantage of her rising to administer an early breathing treatment, since we missed her 3rd one yesterday...too little time up between treatments. She transferred well and easily going into and out of the bathroom, stood well, was animated and chatty, her forehead felt cool to the touch. I can hear, through the monitor, that her breathing is not what it should be, but this is, at this point, a good thing, as I can also hear her attempting to expell congestion, which is good. Each time I hear a particularly loud attempt at expellation, I peak into her room. She's sleeping through all of this, although the monitor assures me that it's not the most restful of sleeps. Thus, I'm preparing for the possibility of a "hang dog" day...but, you never know. I'm going to let her go until 1300, as we decided when she laid back down this morning. Although I mentioned the possibility, last night, that, if she wanted, we'd try letting her walk into the bathroom for bathing, I'm keeping her options open on that one. If she's hung over from what has been a challenging night, I may insist on one more full wheelchair day, then reevaluate every time we come to a crossroad requiring leg movement.
Interestingly, although I didn't even think to consider pneumonia until the tongue thickening happened, once that possibility appeared, I didn't freak, nor did I buckle, at all, at the possibility that this is most likely going to be typical of my mother's trajectory and that more "To Treat or Not To Treat" decisions will probably be littering our path with increased frequency. As well, I am pleased that, during the worst of her weakness, I quickly figured out a way to use my body to support my mother's weight during transfers when it was obvious that she couldn't, and managed this without doing it in such a way as to compromise my back. On Wednesday, while chatting with the Hospice Social Worker after his visit with my mother, I reported to him that my next "fear on the horizon" was the time when my mother wouldn't be able to help in transfer and would become bedridden. He assured me that as long as my mother could sit up, there would always be some sort of "trick" to help her move from spot to spot, even if she became to weak to help in her own transfers. That, he said, is what the OT people are for. Then, less than 12 hours later, I found myself in this position and discovered a trick for myself, on the fly. This gives me great confidence; not that it will be easy, but that, no matter what happens, one way or another I will be up to it.
Oh, wanted to mention, off topic, just so it's here, my mother did develop a knot on her back where her tailbone used to be (she broke it and it was removed when she was in the Navy) from the "cleaning drawers" collapse on Thursday. It doesn't hurt her, though, even when I press on it, and doesn't seem to keep her from sitting comfortably or, as we discovered yesterday, from moving, when she's of-a-body to move. Her left arm continues to improve. Although, when concentrating at my direction, she still doesn't seem to be able to raise it enough to use her slip-on blouses, I noticed, last night, when she was in the bathroom before retiring, she was raising her left arm so that her bicep was at a 90 degree angle in order to preen her hair (which needs washing).
I also want to mention, so that I remember, when she was "fever sweating" over the last few days I detected a sharp sweat odor after each episode. Her sweat (little that there is) usually doesn't have a noticeable odor. I've never noticed this one, although it's been a looooong time since she's had fever sweating episodes here at home. The last ones were at the hospital and the rehab facility, respectively. During these times there were so many other competing odors that I never noticed this one. This morning I took extra whiffs when I was close enough to her to do so without being detected. Nothing, other than the usual odor of underwear that needs to be changed. Her forehead felt, as she often says, "cool as a cucumber". I can hear through the monitor that she has been settled down for awhile, now. Depending on how she appears when I enter her bedroom to awaken her at 1300, I may let her sleep until 1330 or 1400. I know the extra sleep, especially if she is in peaceful repose, would probably be good for her.
So, on we go, hopping down The Tumor Trail. It doesn't seem as though she's "dying". It just seems as though she's living, more slowly, with a bit more difficulty, but continuing to live, nonetheless. You'd think, by now, I'd have developed some sort of idea how her life will end...but I haven't a clue, and, frankly, I'm glad I don't. Mom & I both like surprises.
Today I eased into a nap to the sound of my mother breathing.
We received the "nursery" monitor, to which, I think, from this point on, I'll refer as the "nursing monitor", as my mother's bedroom is certainly far from a "nursery". Before we received it I worried, a little, about what it would be like to listen to my mother breathing. I was sure I'd hear it, since she breathes so loud and so quickly. I was concerned that it would create a less than restful sleep environment for me. I was exhausted, today, though, after the tight and demanding schedules of the last few days, and knew I'd need a nap. I was surprised to discover that although my mother's breathing is heavy, normally, and loud enough so that I can hear each breath through the monitor, it's also regular, rather than ragged or forced and, surprisingly, soothing. I was so delighted to discover that it is not at all disturbing to listen to her breathe that, just as I dozed off, I found myself thinking about how one of the methods of learning to meditate is to concentrate on one's own breath...so, I wondered, what class of meditation is involved in concentrating on someone else's breath?
I also recalled, while settling down, using a technique I'd learned from drummer Mickey Hart on a PBS interview involving synchronizing one's heartbeat with that of someone who needs to be calmed, then soothing their heartbeat by consciously slowing your own down. This worked, once, when I tried it; it involved laying down with the person with my chest up against the person's back. I wondered if I could do something similar with my mother's breathing.
Anyway, it's fascinating to listen to my mother on this transmitter. Tonight I listened to the sounds of her settling down into sleep. I noticed that she quietly clears her throat several times, then, suddenly, the clearing stops. I assume that this signals that she's "under".
Speaking of breathing, the Hospice Nurse today recommended two things:
- An O(utpatient) T(herapy) C(onsult): Designed not so much to strengthen my mother, although if it appeared that this was worthy perhaps considering taking a stab at it, but, primarily, to evaluate her obvious weakening for suggestions, methods, "tricks", as the Hospice Social Worker mentioned, that would help us handle her physical weakening without becoming overwhelmed. I, of course, jumped at the chance.
- She (we had a "sub RN" today, one we've had before and with whom we work very well) also suggested a breathing exercise that might help my mother clear her lungs, better, and get her coughing when her strength for this seems to lag: Three times a day, have her take three deep breaths followed by three deep exhalations. We've done this once, today, and it did, indeed, get her to coughing. The nurse mentioned that she was hearing "crackling" in Mom's right lung, which indicates fluid. Doing something to stimulate coughing might help her clear her lungs, especially considering her obviously weakening state.
Abrupt end, tonight. I'm pretty wasted, even with the nap. And, I should get up early tomorrow, in case the Construction Guy calls to let me know he can install the cross grab bar tomorrow instead of Friday. When he left this morning he still wasn't sure if the bar which is being specially made, would be ready.
Oh, I should mention, the non-emergent paramedics were called, again, this morning. You can read about it here.
Today we are having safety bars installed...
...in the bathroom and through the hall. All, I think, but one will be installed today before my mother arises. We've postponed the nurses visit so that we can get these in. I know, I know, this is something we should have done some time ago. The absolute necessity of the bars happened yesterday, when my mother's incredible grip and arm strength pulled the towel rack, which we've been using for ages successfully, from its sockets, yesterday. She wasn't hurt. Nor was I (I was holding onto her, at the time). Here is a rundown of the incident.
In case you've not ever run across this necessity but expect it to appear in your future, you might be interested to know that "handicapped" grab bars are, astonishingly, not manufactured to fit from stud to stud, in most cases. This is the primary reason why bars are often installed on the diagonal. I discussed this with the Construction Man we've hired to put in the bars. He was the one who brought it up, when I mentioned my concern that my mother has, in the past, not been handy with diagonal bars and, at this point I am more than reluctant to expect her to adjust to something which has always felt unnatural to her. We are solving the problem, in part, by installing two bars here and there where, if handicapped bars were made for normal houses, one would do. In once case, we are having the Construction Company make a bar to fit.
So, my mother will no doubt be delighted to know, I am going to let her sleep in until the bathroom bars are installed. This probably won't be much past her 12-hour-sleep-mark, but she always appreciates extra sleep, no matter how little or how much.
I'm relieved to be having this done. Although I trusted the current arrangement enough to rarely think about it, I also always autonomically braced myself for a possible malfunction in the bathroom. Luckily, our bathroom is so small and close and I am always so THERE with my mother (in the bathroom or out) that the malfunction that finally occurred didn't throw us. But, you know, it's time, finally, to do something about this. Last night wasn't really much of a problem without the usual support, but I'm looking forward to being able to relax a bit more and use my body a bit less in the bathroom with my mother, now.
An interesting "sidebar" (excuse the pun, which is intended: The Construction Man (who is one of two owners of the company) told me that he and his brother (the other owner) briefly considered devising, manufacturing and selling support bars to fit existing studs (which are pretty uniform throughout building construction, even going decades back). Upon researching the possibility they discovered why no one else has leapt to fill this obvious need: Aside from the patenting process, with which they were prepared to deal, a variety of other government agencies are required to be involved for "safety" and "certification" purposes. In fact, one of the bars, the one that the company will be making for us, will neither be certified nor is it regulated, but it is exactly what we need.
As well, our Construction Man told us that the companies who manufacture and distribute these bars will tell you flat out that installing them during the construction of a building is the preferred method because of their "off-stud" size.
"But," I said, "I would guess that this hardly ever happens! How many people build custom homes when they are at the age where they anticipate needing support in their elderly years?!?"
"Exactly," he confirmed. "Although we build homes, too, and have built a few with stuff like this installed, almost all our grab bar business in in existing homes." He also told me that, although there is a "trend" toward building homes that already have supports like this installed, it is not a healthy trend and these houses don't sell as well or as quickly as homes without pre-installed support devices. "I think," he added, "most people, when they're buying a home, aren't interested in thinking about what they're going to need when they are old enough to need support to get around. It's probably a turn-off. I built the home for my family and I didn't think about this, at all."
Although "The Media" is trying hard to turn the public's head about this dilemma in regard to buying houses already fitted for future support needs, truth is, you can't fight human nature. What I find curious to contemplate is that the support device industry, at least in this country, completely ignored the basics of building construction when designing support bars in the first place. I mean, it certainly wasn't a conspiracy...it was simply a lack of foresight and competent construction thought.
I haven't been absent...
...really, I've been here but buried in the other sections of these journals, now known as the "Archives". I've been correcting links, going forward archive by archive, and reattaching search engines to everything as I go. I've just started on the fourth archive, the one for 2006. It's going quickly, since I'm not reading posts, just scanning for links, checking them, correcting them, if necessary, and going on. I'm even checking and correcting external links and adding links to articles I cite from the New York Times, since they have opened their archives to the "unregistered" public within the last year. It's surprising how many websites either rearrange their pages, move or extinguish over time.
A fair amount of what has been going on in our home is showing up over at The Dailies or at Life After Death Sentencing. If you haven't been over at either, Mom is recovering slowly but surely. She's having a few problems with feet swelling (minor), which, I think, is due to the fact that it's been difficult for us to figure out a strategy for getting her up to pull her slacks down, but I think we may have overcome that tonight. Since she was having trouble raising herself from her rocker for a moment for me to pull down her slacks, we tried having her rise with my help then attaching her to the walker, but she's got the heebie jeebies about the walker, right now (I don't blame her; she fell while she was using the walker), so, as soon as her hands were on the grips she'd fall back into the chair, giving me no time to grab her slacks and pull. We tried having her hold onto my shoulders, too, while I pulled her pants down, but I almost fell over backward from the weight of her leaning on me, so we decided that wasn't a good idea. We tried standing her with my usual assist and transferring her hands to the arms of the wheelchair but even with the wheels locked it isn't sturdy enough to stay in place while she leans over it...and, again she collapsed back into the chair before I reached the back waistband of her slacks. I'm having her attempt to raise her arm straight out in front of her at odd times during the day. I also take hold of it, have her relax, and stretch it out and move it up. The results are better when I'm doing it, but she is recovering some movement on her own. I am now convinced that she didn't fracture anything...just received a very bad muscle whack. Her shoulder isn't a problem at all, anymore, just the back of her bicep and sometimes her forearm, which occasionally aches from the additional load it's taking on when she rises or walks. She's on pretty constant acetaminophen, 500 mg at a time, four times a day. She decided to refuse it, tonight, but after the transfer from the rocker to the wheelchair in the living room as we were heading in for night prep, she commented that her legs were aching from "all the exercise" she'd gotten today. When I asked her, again, about "taking a Tylenol", she assented.
She is still completely enwrapped in Touched by an Angel episodes. I'm not sure what we're going to do when we get through the four seasons that are available. I'm hoping, if she's still heavily into them, that she'll have viewed so many that repeats will work. Otherwise, maybe I can get us back to reading, again. I've tried over the last week and Angel episodes are continuing to trump books.
I'm seriously backed up on stuff I am planning to post; a couple of book reviews, another essay, etc. But, I suppose, it's probably better to be behind than to have nothing left to do!
Maybe I'll do a little more link checking before turning in. I'm figuring that I should be able to migrate this journal over to the domain in a week or less. I'm not going to wait to check links in The Dailies until after everything is securely domained. Between the archive and the current area on that section there are 1500 posts and counting. The minor sections, like the food section and the moving archive, will have to wait, too. So will the movies section. I'm figuring I should be able to migrate this journal and reattach the search engine in about a week...then I can breathe a little more slowly and take the rest of the link checking as it comes.
All material, except that not written by me, copyright at time of posting by Gail Rae Hudson