Medical update – 111209

It’s been another long interval since my last report, so I’m checking in with the latest from Lake Woebegone.  Actually, we left Lake W nearly two weeks ago and can almost say we’re finished unpacking and getting things to their rightful (albeit new) places.  Lisa’s done another wonderful job of making this house a home.  And being the Christmas animal that she is, The Tree is already up and lit and will soon be decorated.

On the parental side of things, Pop seems almost like he’s smiling these days.  It’s really quite pleasant to behold.  Yes, he does still occasionally get his digs into Mom, but not nearly as often, and not nearly as sharp.

Mom had her 2nd post-surgical exam with her orthopedist today.  The attached pic shows that the screw is still about a turn-and-a-half out from the bone just as it was in the last x-ray.

Latest left elbow

On a pain scale of 1 to 10, she claims to suffer a steady “3” in the elbow area and says that it’s tolerable without pain meds.  The doctor suggests waiting a few weeks after the conclusion of physical therapy to see if the pain will go away of itself.  If not, Mom can elect to go in for a 5-minute out-patient procedure in which she would be given nitrous oxide (laughing/sleeping gas that dentists often use) so she wouldn’t feel the incision or the removal of the screw through a tendon.  For the moment, she wants to wait.  But if the pain remains in a couple of months, she will be encouraged to go for the removal.

I spent an hour with the Piedmont Place Nurse Practitioner yesterday.  We went through both M&P’s medical profiles at length.  I asked many questions and got good medical answers.  But the main takeaway is an even deeper conviction that M&P are in the right place.  Because the folks are elderly, close watch is kept on their status in every area of life.  If Mom falls in the bathroom, they look for medicinal, neurological and physical answers for why it happened.  They then make slow and careful adjustments to meds or whatever else is necessary to minimize the chances of it happening again.  This is why Mom allegedly didn’t sleep for 3 weeks.  A slow adjustment was made to her pain/sleeping meds which turned out to be a cutback of too much.  So a slow adjustment was made upward again.  You get the idea.

Mom has become her own advocate, and this is a very good thing.  She will find the NP or a head nurse and tell them what’s up.  They know to not take everything Mom says at face value because her impressions are often skewed or outright wrong.  Nevertheless, the information is sometimes helpful, and will sometimes cause a change.

What…Mom wrong?  Yep.  Constipation is one thing, but 3 weeks without a bowel movement is highly unlikely to nearly impossible (x-rays showed plenty of stool, but no compaction or blockage).  3 weeks without sleeping?  Also unlikely.  Poor sleep, yes.  No sleep, no.  Slipped on something wet each time she fell in the bathroom at two different facilities without evidence of ANY moisture?  Not so much.  Diagnosis?  Early-stage dementia.

Possibly related (or not) is her waffling on what comes next.  She will graduate from physical therapy next Friday.  On that day, PP housekeeping will move most of her things from her rehab room to an Assisted Living room.  Mom herself is scheduled to move the next day.  She told me today that she doesn’t want to move because “the sink is in the middle of the living space.”  I didn’t say anything.  Oy !

Two more quick stories.  While we were at the orthopedist’s office today, Mom missed her lunch at PP.  When we returned, a nutrition staffer literally ran to catch up to Mom, and offered to bring her lunch.  Declining that (she said she had eaten too much breakfast), the staffer offered a sandwich, then a snack, then Ensure which Mom finally accepted.  I’ve witnessed this now many times…people will hunt you down to give you meds or dinner or get you to a PT appointment, etc.  There are lots of places to hide in this huge facility, but the staff will always find you.  Freedom without missing anything important.

Mom had another scheduled visit with the PP psych who for some reason thought potassium would be a good thing for Mom and recommended her eating a banana each day.  The potassium idea is a good one.  But bananas are also known to contribute to constipation.  And that’s why I’m here…to ensure continuity of care even within a single facility.

On the lighter side… Mom and Lisa and I are conspiring to buy a bunch of general greeting cards and Christmas cards and postage.  Pop can’t say a thing, and that gives Mom some degree of pleasure.  I will also create a page of return-address labels for her, and will make address labels for her Christmas cards, too.  This lessens the amount of writing she has to do; something that causes her discomfort…plus her handwriting is deteriorating quite a bit.

Another tome.  I hope it hasn’t been too boring.  Just trying to be informative and accountable.

Have a Good day !            Fred

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About FredMarx

Old enough to have wisdom; young enough to learn.
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