Report from Pillville: The cardiologist, the neurologist, and Rx for mail and paperwork

My mom, center, 15 years or so younger than I am right now. Me, lower right.

My mom will be 90 in September. I've known for sometime now that her junk mail needs to be spirited  away before she sees it. Those of you who might have elderly parents living on their own whom you suppose are doing fine, this is a cautionary tale. Check around for commemorative coin collections the next time you stop over for a cup of tea. Then have a seat while you consider how much coinage was spent on these pieces of junk. In my house here's an entire shelf in a large antique armoire devoted to these scams that prey upon the elderly. I think my mom has forgotten that she's ever purchased these, so we don't have to discuss why she shouldn't purchase any more. Thank god.

The real mail, I assumed, was getting filed in the file box in her room. There isn't much, but I have noted over the past couple of months that the to-be-filed pile was growing. When the late notice came from Master Card, I had the confirmation I needed that my mom was in over her head. "I don't know what these papers are," she said. She can't tell a bank statement from a credit card statement--which is why I'm now in charge of that (lord, help us all.) So I spent a little time filing today. It wasn't hard. I assured her it was all organized. Nothing overdue. Everything put away. "Good," she said. "These papers...I can't...My head is full of other things. I just don't know what things."

"No worries," I said as all of the Committee to Preserve Medicare stuff went into the recycling. Really, I think I should be the one worrying about preserving Medicare--not my mom.

And meanwhile, last week's visit to the cardiologist was uneventful. Her heart is a 90-year-old heart. Not much else to say.

"Any violence?" the neurologist asked me when we went to see him the next day.

"Violence?" I asked. Apparently things can get nasty as cognitive decline sets in. My mom seems to be getting sweeter. She's forgotten a lot, but not how to be nice. Not how to love me. And she loves everyone who visits. She loves their clothes, their pretty hair, their tattoos, their dogs. Everyone, to her, is just the most marvelous guest ever.

Report from Pillville: Dementia...and...Puppies!

When I have a moment or two here in the Kingdom of Pillville, I sometimes take a little Google tour of the questions that have been patiently waiting in the back rooms of my mind. Here's a souvenir from today's tour: types of dementia. Sometimes my mother's memory loss is startling. Certain old stories seems stuck like glue, while other pieces of her past have simply dissolved. Or like she's cleaned out the closet in her brain. Keep this. Get rid of that.

Sometimes a conversation takes a weird turn like tonight when we began talking about the grandchildren she's lost track of due to an acrimonious divorce. "Those boys might be farmers," she said, insisting they could farm the acreage they grew up on though said acreage has never been actively farmed by them or their mother. I feel like I might be coming down with some kind of sudden-onset dementia during conversations like this. I go micro instead of macro, trying to figure out if she means who I think she means or if I wasn't listening carefully. Or if the land was actually farmed--maybe a hobby farm all these years, and I just didn't know. Or if she means they might farm their other grandmother's farm which really was a farm. I ask too many questions trying to straighten out the snarl of information I can feel tightening somewhere around my cerebellum when I should probably just say, "Yep, those boys might be farmers! Yep, they sure could be farmers!" And then change the subject.

my mother and her twin sister and their brother and one of the family milk cows--now these kids could have been farmers!

Tonight's conversation ending up with her exclaiming that anyone could farm if they just got a horse and a plow--or a tractor. I wanted to say that nothing is farther from the truth. And get into how, nowadays, most people in the U.S. would starve if they had to grow their own food. But I didn't get into that.

We talked about raising puppies instead, and I whipped the iPad over to the table and showed her pictures of the St. Bernard puppies that my brother's wife's brother (Are you following me? It's a little test....) and his family raise in Iowa. Puppies. There's a subject that can rescue a lot of dinner conversations. Go ahead, try it. Before you start feeling like this:

my mother's mother--as posed by her son (the young man in the photo above) who, I'm told, had quite a sense of humor

Two Things that Made My Day/Happy Saturday to You

THIS ARTICLE in the New Yorker about the way a nursing home cares for elderly patients with dementia.

This poem by Jack Gilbert:

Older Women

Each farmer on the island conceals
his hive far up on the mountain,
knowing it will otherwise be plundered.
When they die, or can no longer make
the hard climb, the lost combs year
after year grow heavier with honey.
And the sweetness has more and more
acutely the taste of that wilderness.


And because the name of the nursing home mentioned in the New Yorker piece is Beatitudes, I'm going to toss this into your day, too. 

From the King James version of the Bible:

Blessed are the poor in spirit,
    For theirs is the kingdom of heaven.
⁴ Blessed are those who mourn,
    For they shall be comforted.
⁵ Blessed are the meek,
    For they shall inherit the earth.
⁶ Blessed are those who hunger and thirst for righteousness,
    For they shall be filled.
⁷ Blessed are the merciful,
    For they shall obtain mercy.
⁸ Blessed are the pure in heart,
    For they shall see God.
⁹ Blessed are the peacemakers,
    For they shall be called sons of God.
¹⁰ Blessed are those who are persecuted for righteousness’ sake,
    For theirs is the kingdom of heaven.

And because I've spent the last several months living with a person who is very hard of hearing, there's this:

Watt is the What?

"I just pushed the circuit breaker switch back to the "on" position," I said. "Now I'm going to turn on each lamp and light switch that are on that circuit and see if the breaker trips again." My mom stood in the kitchen in her pink flannel snowman pajamas nodding. I started with the living room lamp in the corner, then proceeded to the next lamp, then the light switches that turned on the hall lights, the outside lights, and the light at the top of the stairs. The house was blazing with light and everything stayed on. "Success," I told her. "Look, it's all good." We had a brief discussion then about why the breaker blew in the first place. I couldn't explain that. Maybe the breaker is wearing out, was the best I could muster.

"I'll bet it's the furnace," my mom said. "The heat came on and blew everything out."

"Nope," I said. "Couldn't be the furnace, because the heat has been working. That's on a different circuit." She nodded. "Well," I said, "I'm going to go run my errands."

"So, what time is the electrician coming?" my mom asked.

"He's not," I said. "It's fixed."

"We don't want the furnace to go out," she said. I explained about the furnace being on a different circuit again and went on my merry way.

I'm never quite sure what is happening when my mom and I fail to communicate. Is it the hearing aids?
Dementia or maybe a negative result from the Namenda? True, she's 88 and grew up as one of the "rural poor" which in her case meant kerosene lanterns in a log cabin for part of her upbringing, but I'm pretty sure she used to know her way around a fuse box--at least well enough  to stand behind my dad with a flashlight while he changed a fuse.

Maybe part of what gets in our way is her definition of gender roles. More than once, she's said that I should wait until the man who loves me appears for the weekend to perform this or that task. A couple of times she's said that it's too bad that I don't have a man to do things for me--so maybe she didn't believe that I could get the lights back on. Maybe she's afraid that due to my "tinkering" we'll be plunged into cold and darkness or electrocuted while using the toaster. I can't say, but communication is a complicated business even when our hearing and our brains are functioning well.

I had a mini freakout inside my head the other night in the emergency room when the doctor asked her how long she'd been having the pains in her abdomen. "Weeks!" she cried. "Months!" The doctor looked at me and frowned. I saw my self being photographed in profile, then from the front with a number under by chin. Oh, good, I thought, now I can add elder abuse to my rap sheet. I explained to the doctor that while my mom often complains of stomach cramping in the morning, she's consulted with more than one doctor about that, but the recent acute pains were something new. I guess I'll be allowed to walk the streets for now. But if I call you in the middle of the night, listen carefully. If I say I'm in prison, you might need to take me literally. Then again, I might just be talking about how I feel.


photo credit: expertintegratedsystemsblog.com

Report from Pillville: The Neurologist

The first visit to my mom's new neurologist was yesterday. She was referred by her primary care physician due to the fact that she has sleep apnea and narcolepsy--which actually don't seem to be much of a problem these days. The neurologist thought, at first, that my mom might be better served by seeing  a "sleep specialist," but I told him we wanted to discuss her potential for Alzheimer's due to the fact that her twin sister suffers from it. I wanted to know what he thought about the drug, Aricept, which my mom is already taking, and if there was anything else he might prescribe to ward off any further memory loss. While my mom's short term memory is good, there are little pieces of her past that have slipped from recollection. "I had whiplash?--from a car accident?" she asked me today when she saw that I had written it on her medical history form. "I have high blood pressure?" she wanted to know as we were discussing her meds with the primary care doctor a few weeks ago.
"You can't remember every detail of your life," the neurologist said, but he gave her a memory test. She scored 30 out of 30. While wearing loaner hearing aids. While deciphering his questions through his Chinese accent. He had to give her a hint at for one of the words she was supposed to remember. So maybe her score was really a 291/2. I think she enjoyed the challenge.

The neurologist's recommendation for aging well with a healthy brain? Stay thin. Have an active life-style. Read. Be socially engaged. Avoid pesticide exposure. Turns out there's a link between pesticides and neurological problems.

Yikes.

There's a lot of agriculture here in Margaritaville. The wind blows straight off the ocean though. Still, it's worth looking into what is sprayed on the crops here. "The air from the ocean is the best air to be breathing," the doctor said. "There's nothing out there except the Channel Islands, and there's no agriculture there."

I will be renewing my commitment to organic produce. And continuing my morning walks on the beach. My mom walked an entire block--and back--tonight. And she told me that she might try to quit smoking. Maybe after a visit to the podiatrist, she'll be walking on the beach with me.

Oh--I almost forgot-- ; ) the doctor prescribed a new pill. Namenda. But she'll keep taking the Aricept, too.

The net prescription medication count since her arrival here in Margaritaville? She's been taken off of three meds, now added a new one--for a grand total of ten. That does not include the martinis.