If there were any indication that it would be worth the trouble to deal with a very annoying side effect, we might hang in there in hopes that the problem would eventually subside.  There is no clear evidence that the Pyridostigmine (brand name, Mestinon) has had any impact on Mary Ann’s fainting spells (syncope) due to the Orthostatic Hypotension (sudden drop in blood pressure when standing up).

It has only been a little over a week, but multiple trips to the bathroom each day with something close to diarrhea has worn us both out.  Most of the times there has been too little warning to get there in time.  Each medicine brings with it a cluster of side effects.  There are no perfect meds.  There is always a balancing act weighing the benefits against the problematic side effects.

Since the high blood pressure is such a serious problem, this is no small decision.  We will continue the Midodrine at the lower dosage we started just before adding the Pyridostigmine.  The Midodrine keeps her blood pressure at a higher level than is healthy for her in the long term, but it reduces the number and intensity of the fainting episodes.  We will accept the vulnerability to fainting spells that comes with the lower dose of Midodrine.  If those spells increase to the extent that they are stealing from us the capacity to have a reasonable quality of life in our time together, we will increase the dosage of the Midodrine to last summer’s level when the fainting had gotten out of hand.

The last two days have kept us inside for the most part due to bad weather.  It is at times like these that it becomes clear again that 24/7 with one another it tough to maintain.  The needs that come so very often become harder to deal with in a pleasant and patient way.

Gratefully, we have a treat tonight away from the house.  It will be a challenge, since the wind chill today has never gotten above zero.  The air temperature is heading to zero or a degree or two below by morning.  The treat is too good to pass up.  It is a Christmas Concert by the local Symphony.  What makes it such a treat is that a young woman who grew up in the congregation I served is singing at the concert.  Her Mom is on the Staff at that church.  She has the most beautiful voice I have ever heard. She is based in Boston now, and, on occasion is a vocal soloist for the Boston Pops. Check out her Blog for a real treat: http://kristenwatsonsoprano.blogspot.com/

Arranging to get to the concert was no small task. Mary Ann wanted to go, but I could not be sure she would not be able to go at the last minute.  Then came the prospect of getting there and at some point needing one or more trips to the bathroom.  Given the side effects of the new medicine she was taking, that was pretty likely.

While I do not yet know exactly how the evening will go, I realized how important it was to me to be able to experience the evening’s music.  I called the Agency, Home Instead, that we have used in the past.  The Companion Care Aide who came on Sunday mornings before I retired was available.  She committed to coming this evening to be with Mary Ann here at home if need be.  I called to buy a ticket to the concert for the Aide so that if Mary Ann could go she could be there with Mary Ann to help her to the bathroom.  To my surprise, a complimentary ticked now awaits us if we need it.

Enough for now.  Tomorrow’s post will include a reflection on the evening.

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