March 19, 2010

Good Friends — Great Day!

Posted by PeterT under Daily Challenges, Family, Help from Others, Meaningful Caregiving, Practical Tools for Coping, Relationship Issues, Therapeutic Activities, Uncategorized | Tags: , , , , , , , , , , , , , , , , , , , , |
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By the time they arrived she was a little more subdued.  When she got up this morning, she was her feisty self, the one I have known for almost 48 years, smart-ass comments and all (excuse my French as we used to say — no offense intended to those of French ancestry).  There was laughter wound into the interactions.  It was a good morning.

In the course of our interactions, she asked me to tell her about what went on last weekend.  I asked for more help in determining what she was referring to, since I couldn’t remember what went on last weekend.  I thought maybe she was referring to the trip to Oklahoma a couple of weeks ago.  She said that maybe it was just a fantasy, but she recalled events including (again) my wedding to Lulu, this time including some sort of Evangelist and someone stopping the wedding just in time.

I reiterated that I refuse to marry someone named Lulu and she is not going to get rid of me by palming me off on some other woman.  She is stuck with me to the bitter end, mine or hers.  This time she did not seem upset about what she was remembering.  She seemed to understand that it was not real. The conversation was clear and rational, if the content was not.

After such a good hour or two, she needed to use the bathroom.  She fainted three times during our stay there.  Each time we got up for me to do my part in the task, she fainted again.  They were not just momentary lapses but substantial ones.  After that series of episodes, she was very tired and her eyes slammed shut.  If no company was coming, she would probably have gone to bed for a couple of hours or more.

Since company was coming, I did not offer and she did not ask to lie down.  When the crew from Kansas City arrived, she was able to rally to a level of alertness that allowed good interaction for a number of hours as we talked, ate out, drove around a bit and returned home.

When we ate out, she fed herself the sandwich.  Yesterday, she had fed herself some of the time.  When the huge cup of ice cream came after lunch, she insisted on trying to eat it herself.  She often turns the spoon upside down when eating.  It is hard to watch without trying to turn it right side up, but when she is in her determined mood, she refuses to change that pattern.  Finally, after I asked her quietly if she would let me help, she agreed.  At that point she had been working a long time without getting much ice cream into her mouth.  As has happened before, the love of ice cream trumped the pride standing in the say of getting it into her mouth.  It does seem to me that she is regaining a little of her ability to feed herself.

What we did was quite secondary to doing it with folks with whom we have a long history, folks with whom we can be ourselves.  They are folks who have come to be almost extended family.  They are all University of Missouri grads and have little use for the Kansas teams.  None of us is perfect.

In the crew of eight of us there have been struggles of all sorts.  We each have stories to tell.  One in the group has had a chronic form of ALS that was diagnosed maybe eight or so years ago (not sure of the exact timing), long after symptoms of something had been apparent. She, her husband were not able to come since she broke her knee cap and is finishing up a long rehab.  The wife of one who came could not travel yet after a painful test for a problem yet to be diagnosed.

Mary Ann slept on the couch for a couple of hours after they left.  She just did not want to go in the bedroom to nap.  I am inferring from her reluctance to nap in the bedroom lately that she feels if she is in the living room or kitchen, the napping will not be as long.  She will not lose as much of the day.  She will still be in the heart of activity, even if dozing.

The project is continuing to progress.  The sheet rock is up and the first coat of mud is almost complete. It will need to cure until Monday, when Mary Ann’s friends from Junior High years on will be visiting from Northern Illinois.  That is, of course, when the sanding will begin.  The girls and Mary Ann may need to spend time in the lobby sitting area of the hotel to avoid flying plaster dust.  It will be nice to have an alternative place to spend time. After having the view through the sun room glass (even though still covered with cloudy plastic sheets) for a day and a half now, I cannot even imagine the house without it.

After getting up from her nap, Mary Ann was not hungry and would not eat any supper. After I started eating some leftovers, she did eat a few chips and a cookie.  I have little doubt there will be a need for food some time during the night.

While there is no clear reason for Mary Ann to have been doing so much better the last few days, we will take it and simply celebrate.  We have certainly had more than our share of bad days and there will be more to come.  As always, they will come one at a time.  We will deal with each when it arrives.

If you want to write a comment about this or any of the posts on this blog, look to the column on the right side of this page, titled “Recent Posts,”  click on the name of a post and you will find a box at the end of that article in which you can write a comment.  Clicking on the title of the post you are reading will accomplish the same thing.  Comments are appreciated.

 

March 12, 2010

And the Walls Came Tumbling Down

Posted by PeterT under Daily Challenges, Help from Others, Hospice, Meaningful Caregiving, Practical Tools for Coping, Therapeutic Activities | Tags: , , , , , , , , , , , , , , , , |
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Not yet, but there are seven guys with trumpets of rams’ horns followed by a large crowd who have been circling the house for some days now.  Should I be concerned??

The addition of a sun room that will change exterior space into interior space adding a six foot by nine foot sun area with twelve feet of floor to ceiling glass (six feet of which is sliding doors) is now in the process of construction.  The new exterior walls are almost done.  The old interior walls will be removed some time in the next few days, probably Monday.

We now spend most of every day and night in this little townhome, 1150 square feet upstairs — easy to care for but somewhat confining.  The large pondless waterfall that we put in last summer is wonderful, but not visible from inside the house.  When this project is complete, the waterfall will be in full view.

Mary Ann’s assessment of the project is that I have really gone overboard.  I think when all is said and done, she will like it very much.  She has never enjoyed going out and spending time on the deck.  This way she can see the beauty of the area behind the house from the warmth or the cool of the house.

I will make no pretense.  This is for me.  I am nurtured by the outdoors.  I crave light.  This will provide access to both while still in the same space as Mary Ann, keeping her in full view.  When the project took shape and the deal was consummated, it was not so clear that Mary Ann was declining to the degree that is now apparent. It seems to me that the timing is actually working out well.  This is a helpful distraction from the focus we have had on preparing for the next phase of our lives.  The project feels very life affirming to me.   Yes, we are spending the Kids inheritance!  They know it and have encouraged us to do so.

The last couple of days have included two nights of adequate sleep, interrupted, but not too often.  Yesterday she ate well for two meals and missed the third, sleeping through it.  Bath Aide Zandra did do a shower since Mary Ann’s leg strength seems to be returning.  She had problems with her, but got the job done.

Today has included lots of fainting, even just sitting in the chair.  I hope that will subside for a time.  A huge rolling shower chair has now been delivered.  Hopefully, that will make a difference.  The Hospice Aide will come tomorrow for the first time.  This way Mary Ann will get three showers a week.  Since she is incontinent much of the time, it is good to keep her clean.  We change disposables very often (cost adds up fast, but worth it) to avoid urinary tract infections [UTI].

The hallucinations were in a challenging mode.  Mary Ann was popping up to go somewhere and do something much of the time she was out of bed.  I, of course, needed to get to her immediately to keep her from falling.  When I got there, she usually didn’t know what she was up for or where she was going.  A few times she had a need that was created by a hallucination. A few times when she was lying down but awake, she was having a waking dream and talking to me about things that had no connection with reality.  I am sure the hallucination/delusion/dream times are distressing to her, and they certainly are very difficult for me to deal with.

The Hospice Chaplain stopped by to introduce himself.  It is a frightening thing to put two preachers together.  Poor Mary Ann couldn’t have gotten a word in edgewise even if she tried.  He would come at whatever intervals we chose.  Since we have a good support system, I suggested once a month.  His time will be best used with those many who do not have an active support system.  It is nice to have an option that is not part of in our organization or denomination.  He spent a good portion of his career in Brazil.  I suspect he has plenty of interesting stories.

Later in the day friend (and former parishioner) Don came by to check out the project.  He had a couple of good suggestions.  More importantly, he brought a cup of coffee from PT’s.  We stood there talking long enough that the workers thought they might put us to work.

For supper we enjoyed a small Lasagna that Daughter Lisa had made and put in the freezer for us when she was here.  Afterward Mary Ann was willing (of course) to head to Baskin & Robbins to get some ice cream treats to bring home.

She is now in bed.  I suspect, given the hallucinations today, tonight may be a difficult one.  We will see how it goes.

If you want to write a comment about this or any of the posts on this blog, look to the column on the right side of this page, titled “Recent Posts,”  click on the name of a post and you will find a box at the end of that article in which you can write a comment.  Clicking on the title of the post you are reading will accomplish the same thing.  Comments are appreciated.

 

March 10, 2010

Good Day with Good People

Posted by PeterT under Daily Challenges, Help from Others, Hospice, Meaningful Caregiving, Practical Tools for Coping, Relationship Issues, Sources of Strength, Therapeutic Activities | Tags: , , , , , , , , , , , , , , , , |
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It was a very good day today, given recent challenges. The summary is: She went to her Tuesday morning group; the Hospice Nurse visited her; Mary brought Baskin & Robbins (yeah!); and the Hospice Social Worker came and spent some time with us.

Mary Ann decided that she should get to her Bible Study Group this morning, even though it appeared that she was too tired and would not be able to get up in time.  As I fed her breakfast she said something very revealing about her perception of Hospice.  I was not sure how much of what we talked about through the family meeting and meeting with Hospice folks.  She asked what she would be doing the rest of the day after her group study and if she would be spending the night here at the house or not.  It dawned on me that she had somehow gotten in her mind that enrolling in Hospice meant she would spend her time at a Hospice place.  We do have a Hospice House here.  Our Parkinson’s Support Group meets at a local Hospice office.

I reminded her that one of the main benefits of Hospice was that we could stay home to the very end.  I told her that the Hospice folks would come to us here at home.  It was an interesting conversation.  She seemed to understand.  It did reveal just how significant the decision about Hospice was for her.  When she said yes to Hospice, she must have been saying yes to going someplace other than home from now on.  That is a thought I still could not tolerate.  As strong-willed as she has always been, it has surprised me how readily she has generally accepted what the Kids and I have thought best for her.  We always made clear that we would honor whatever her wishes were to the extent possible.

At Bible Study, apparently she participated appropriately at the beginning, then soon put her head down for the rest of the time other than pill time.  It is such a wonderful thing that the group is so accommodating to Mary Ann even when she cannot fully participate.

She wanted to eat at the New City Cafe, but thought better of it when we got to the parking lot.  She was still struggling in the car just to keep her head up.  I went in and got her favorite meal there, the Seafood Tortellini Salad to take with us.  When we got home she ate lots of it, along some bread they sent with it and her usual Pepsi.

Early in the afternoon, Hospice Nurse Emily came by.  She is young and enthusiastic.  She did a great job with Mary Ann, who was in bed napping by that time.  She took her vitals and checked her out.  Again, her blood pressure was pretty high. The equipment company had delivered the wrong style shower chair.  When Nurse Emily got back to the office, she followed up with the supplier and, hopefully, a more appropriate chair will be delivered tomorrow.  Bath Aide Zandra’s Supervisor called and said that tomorrow’s usual shower and hair washing would be a bed bath instead.  I am hoping the shower chair will allow showers to resume.

Another reason that I am hoping the showers can resume is that Mary Ann seems to be regaining the ability to help in transfers from bed to transfer chair to shower chair to the chair at the dining room table.  The curled hands seem to be loosening some.  It may still be wishful thinking, but it seems that her hands are also less swollen.  The medication, Amantadine, that was stopped certainly has a powerful impact.

The Hospice Nurse will come twice a week, Tuesdays and Fridays.  We can cut that back to once a week if that often does not seem necessary.  Soon after Nurse Emily left, Mary came by for a visit, bringing the Baskin & Robbins ice cream treats.  Mary schedules the Volunteers who visit Mary Ann.  As I have mentioned on occasion, we use the free website http://www.lotsahelpinghands.com to schedule times and days of visits.  It is a wonderful tool.

Just as Mary was leaving, Hospice Social Worker Kristin came by.  She spent quite a while since it was the first visit.  I was pleased at how responsive Mary Ann was with her even when the questions were not easy one word answer questions.  Mary Ann answered many questions about how she feels in different areas.  There were questions about how anxious she was, or scared or depressed or hopeful.  Mary Ann seemed to answer as I expected, with a lower level of concern than most would have in Mary Ann’s situation.  I understood one of her responses well enough to bring up the dreams about our divorcing and the kids divorcing (all not true, of course).  She admitted that those dreams were upsetting to her.

Social Worker Kristin also asked how I was doing in all the same areas.  As I responded, it seemed to me that while I am experiencing fully all the dynamics of our situation, it is happening in a fairly healthy way.  When she asked if I was grieving, I answered by saying I am using the pay-as-you-go plan.  I am trying to surface the feelings and face them as they come, rather than hiding them from myself and others.  She asked about guilt feelings.  I told her that I choose to admit pretty boldly the mistakes of which I am aware.  It was an opportunity to reveal a bit of my understanding of the unconditional love of God.

After that conversation, I felt as if both Mary Ann and I are as okay as we can be given our circumstances.  If we were more okay with them I would really worry about our mental health.  If we didn’t get down and a little depressed once in a while, we would have to be crazy!

I am certainly pleased with the care Hospice is providing.  I am also pleased with so many good people’s willingness to show their concern and do whatever they can to help.  It is as if there are two worlds out there, the one reported on in magazines and newspapers, on the radio and on television and computer screens — and the world made up of the flesh and blood folks with whom we live in community.

Mary Ann did get to sleep last night and slept well.  Me, too.  She ate well at all three meals (I fed her) and she is now in bed.  As always, I will not presume to predict how the night will go.

If you want to write a comment about this or any of the posts on this blog, look to the column on the right side of this page, titled “Recent Posts,”  click on the name of a post and you will find a box at the end of that article in which you can write a comment.  Clicking on the title of the post you are reading will accomplish the same thing.  Comments are appreciated.

 

March 9, 2010

Cherish?? Maybe not Every Moment

Posted by PeterT under Daily Challenges, Help from Others, Hospice, Information on Parkinson's, Meaningful Caregiving, Practical Tools for Coping, Relationship Issues, Uncategorized | Tags: , , , , , , , , , , , , , , , , , , , , , |
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“I am cherishing every moment we have together.”  That is what I said in last night’s post after the challenge of feeding Mary Ann.  I lied!  As terrible as it sounds, I don’t cherish every moment.  At 4:15am after having been aroused for one thing or another multiple times an hour (the last one only five minutes before) Mary Ann insisted on getting up.  I did not cherish that moment with her.  I got her up and out in front of the television in the living room and went back to bed for an hour.  Then she was ready to lie down, at least for a while.

I guess I am a terrible Husband and Caregiver to admit to not cherishing at all times my sick wife on the last leg of her journey from here.  Yes, I do feel guilty about it.  I sound so sweet and loyal and loving when I say I cherish every moment with her.  I am not all those things!  I am just an ordinary selfish somebody trying to live out my life and my relationship with Mary Ann with a degree of honor, expressing my love for her.  I do cherish most of the time with her, extending even into waste management.  I just get grumpy when I don’t get my beauty sleep.  (Who is going to be the first smart-aleck to suggest just how clear it is that I am seriously sleep-deprived?)

Is it the Amantidine that we resumed that is making the hallucinations and restlessness so intense, or, since she had slept four days, were we just due for the usual return of that behavior?  God only knows, and He ain’t telliin’.  How about the idea of somehow trying to get God a wireless router so that he could just email responses to prayers and cries for help??  How getting on that, Steve, Bill?

When Daughter, Lisa was here last week, her Mom slept all but about four hours of Lisa’s visit.  “Lisa, I would gladly have traded last night for one of the sleep days or nights you had when I was gone.”  Yes I am grateful that Mary Ann is napping now.  I gave her the morning dose of Amantidine, still hoping that she will regain the use of her hands and the ability to assist with her leg muscles when being transferred from her chair to the bed or toilet stool or dining room chair or car, should we be able to get her out again.  This almost 67 year old body is beginning to show its age (the mind is still 25 years old, except for the memory which is pushing 90).

At one point last night Mary Ann was convinced that she was not in her bed, but another bed like hers.  She was convinced this morning that the dining room table was not our our dining room table.  In fact when I first tried to transfer her to the dining room chair for breakfast, she refused since she didn’t want to sit next to the bride.  At least when I checked with her, the bride wasn’t Lulu (the woman I married after divorcing her in one of her dream/hallucinations).  She didn’t know who the bride was.  When I asked if she wanted me to turn on the television she said it was “his” television, not ours.

She has been napping for about three hours now.  Yes, I am grateful for the break.  I just don’t want her to sleep too long.  She had a good breakfast, but she has not yet had lunch.  It is after 2pm.  Our Daughter-in-Law Becky relayed an email from a close friend who works for a Hospice.  In that email, she said that people come to need less nourishment at this time in life, suggesting that I can relax if a meal is missed.  Mary Ann always “ate like a bird” — one reason she has never gotten overweight (very annoying) in all our years together.  Other than ice cream, she usually eats what would be the equivalent of a child’s portion (a pre-teen child).

This morning Bath Aide Zandra brought a helper with her since Mary Ann had fainted so many times the last time she did her shower.  Zandra was concerned that Mary Ann had hit her head because she couldn’t get into the right position soon enough to stop her from falling off the shower chair.  She asked about the possibility of getting a secure three sided shower chair so that Zandra could stand in front and be sure she wouldn’t fall to the side.  We had a tubular metal rolling shower chair that we obtained a few years ago.  It turned out to be unsafe because of the reinforcing bar across the front, making safe entry and exit from the chair virtually impossible.

Zandra was a bit distressed to see how much Mary Ann had declined since her visit last Wednesday.  Today Mary Ann could not assist at all in getting from the transfer chair to the shower chair and back.  Mary Ann’s hands were fine last Wednesday but swollen and clubbed (nor sure that is the right word for describing the claw-like form) today.

I just called our Hospice Nurse, Emily, who listened carefully to what we needed for the shower.  She said she would try to find it for us.  In fact, she said that if we didn’t hear from her, one would be delivered tomorrow afternoon.  Holy Mackerel!! That is an unbelievably fast response.  I have seen PVC pipe chairs that looked sturdier, but the last time I searched a couple of years ago, I didn’t see one without a bar in front.  I hope the supplier Hospice uses has something workable.

Mary Ann had an appointment with the Dental hygienist for her much needed quarterly cleaning scheduled this afternoon.  I did try to get her up in time to go, but she declined.  That was at about 1pm.  It is now 2:45pm and she is still sleeping.  Again, she didn’t want to go to bed until after 11pm last night and spent much of the night, especially from 2am or 3am on, up and down.

She slept until some time after 5pm. She ate a good supper, sat in front of the televsion for a while, then headed back to bed about 7:30pm.  At about 8pm she was hungry and wanted a bowl of ice cream again.  After taking some Ibuporfen for back pain and then later taking her night time meds, she is now lying down.  I am not expecting her to settle in without lots of restlessness tonight.  We will see.

If you want to write a comment about this or any of the posts on this blog, look to the column on the right side of this page, titled “Recent Posts,”  click on the name of a post and you will find a box at the end of that article in which you can write a comment.  Clicking on the title of the post you are reading will accomplish the same thing.  Comments are appreciated.

 

March 8, 2010

Mary Ann is Now in Hospice Care

Posted by PeterT under Daily Challenges, Family, Help from Others, Information on Parkinson's, Meaningful Caregiving, Practical Tools for Coping, Relationship Issues, Therapeutic Activities, Uncategorized | Tags: , , , , , , , , , , , , , , , , , , |
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What that means is that we have someone to call whatever comes up.  A Hospice Nurse will stop by a couple of times a week.  We have added one day a week of having an Aide to help with shower and hair.  Mary Ann loves current Bath Aide Zandra, so we will continue to use that paid service.  All the Hospice costs are covered by Medicare.

The Hospice Nurse who enrolled Mary Ann today was already helpful.  Mary Ann declined so much in the last few days since we took her off one med (Amantadine), that I thought we should start it again.  Because these are powerful meds, I didn’t want to do it without professional advice.  This is Sunday.  Nurse Jennifer contacted the Hospice Pharmacist and confirmed that it was all right to restart the med.  The most obvious change was the clubbing of Mary Ann’s hands, rendering them useless — in four days.  We are all hoping that her hands will return to functionality when the med reaches the therapeutic level in her bloodstream.  There are no guarantees that she will regain what she lost.

Mary Ann was a little more responsive this afternoon.  She was up while the Hospice Nurse was here, and she responded appropriately a few times.  She has been sleeping much of the day, but up for breakfast and to get dressed, as well as an hour or two after the Hospice Nurse left.  She was actually lying with her head down and her eyes closed, but at least she was out of the bedroom.  She ate lunch, the usual half sandwich, chips and a Pepsi, followed by a good-sized bowl of Buttered Pecan ice cream.  As hard as it is to hold her head up and feed her at the same time, I am cherishing every moment we have together.

She has not yet eaten supper.  I have been going in to talk with her every half hour or so to see if she is hungry or wants to use the bathroom.  She finally got up to eat at about 8pm.  She ate a substantial supper capped off with a small Boost and ice cream shake.  The Boost should help assure adequate nouishment.

As the evening has worn on, it is beginning to appear that the Amantidine is a very problematic medication.  She is now very alert, unable to sleep, doing some hallucinating, and when she was in bed complaining that she couldn’t move.  She is up and in the living room watching television, sitting up and it is 11:15pm.  There is no sign she is slowing down — I take that back.  She just decided to lie down in bed.  I don’t know how long that will last, but she has been sleeping most of the time for almost five days, so I guess it would be no surprise if she is up many times tonight.

It is tiring be be jerked around so much of the time by medications that wreak havoc with her functionality.  Sometimes they work, sometimes they don’t.  Sometimes they do exactly the opposite of what they are supposed to do.  Then in an hour or a day or a week, they start doing what they are supposed to do — or not.  I will wait to see if her hands open and resume usefulness.  If they don’t, I will talk with the doctor again about the possibility of removing it.  When looking at side effects, Amantidine’s list contains very many of Mary Ann’s problems.  Stopping it seemed to result in the clawed hands and weakness that does not allow her even to assist in a transfer, let alone walk, even with assistance.  Today after restarting the Amantadine this afternoon, it has seemed to produce more strength and alertness, sort of bringing her back to life.  Of course I can’t be sure the medicine is causing all the changes.  It is just that the changes seem to associate directly with the times we stopped and then started again the Amantadine.

Even the professionals, Doctors and Pharmacists can’t help very much since people don’t always react in the same way to the same medication.

On the positive side of taking the Amantadine, if it helps with her alertness and ability to communicate, that will be a very good thing in the next few weeks.  Some of Mary Ann’s friends and family intend to come and visit.  They would appreciate being able to interact meaningfully with her.

Some readers have asked about the time at the Retreat Center — how it went.  I have already written about the two evenings.  The day Friday was wonderful.  It was 70 degrees and full sun all day long.  Thursday night, when heading out to watch the sun set, I was spotted by a deer, who headed over to be with ten more deer.  I watched them for a long time.

During the day on Friday, I walked at a leisurely pace along the path that wanders back and forth through a large wooded area.  The moss on the path was in its new spring shade of green.  The trees were budded out ready to burst open with flowers for leaves.  There were birds to be enjoyed. There were some I couldn’t identify (not unusual).  Even though they are common, the Red-Bellied Woodpecker that doesn’t have a red belly, and the Yellow-Rumped Warbler, that does have a yellow rump are just fun to call by name.

I did see something out of the ordinary.  It is what one of the staff there has dubbed the Mutant Armadillo.  It is certainly an Armadillo, but the largest one I have ever seen, dead or alive.  I suspect it would take five or more of the ones that are routinely spotted on the side of the road with their feet in the ari to match the weight and size of the monster I saw.

I sat for a long time on the three legged stool in the fartthest corner of the property I could reach.  I read Psalm 104, a great description of the creation and all that’s in it.  Then I read the a few chapters in the book probing the implications of physics in regard to the presence of God.  It was a good grounding for me as we ride the roller coaster we are on here at home. I did take a moment to phone home from that place.  I have done that on the last few retreats.  It helps me keep the world of prayer and meditation connected to the day to day reality.

I continue to be overwhelmed by the words of support through the electronic media.  There is no chance to feel isolated and alone when so many are thinking of us and praying for us.  Thank you all for that.

If you want to write a comment about this or any of the posts on this blog, look to the column on the right side of this page, titled “Recent Posts,”  click on the name of a post and you will find a box at the end of that article in which you can write a comment.  Clicking on the title of the post you are reading will accomplish the same thing.  Comments are appreciated.

 

March 7, 2010

Decision is Made

Posted by PeterT under Daily Challenges, Family, Help from Others, Information on Parkinson's, Meaningful Caregiving, Relationship Issues, Sources of Strength, Therapeutic Activities | Tags: , , , , , , , , , , , , , , |
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I am phoning the Hospice folks tomorrow (Sunday) to begin the application process for Hospice.  When we asked in a way that she could respond yes or no, Mary Ann said yes.  The kids both agree wholeheartedly.  I have grieved my way through to agreeing.

It seems none too soon.  I can’t believe how much Mary Ann appears to have declined in just the last three or four days.  She slept through the entire time I was gone, either in bed or in her chair with her head down.  She had been sleeping like that before I left.  She is seldom responsive, but can on occasion be lucid for a while. All of a sudden in the last three days, her hands have swollen and are stuck in a clench, which could become hand contractures, something our daughter saw often in the nursing home context.

Mary Ann was at the table with us during the entire conversation about Hospice, and the decision about the possibility of a Do Not Resuscitate order.  She had her head down but her eyes open.  The kids were sitting closest to her and I was across from her.  We worked hard to get responses from her at various times.  I explained that acceptance by Hospice would imply that we are on about a six month trajectory.  I added that if she was doing better she could “graduate” from Hospice for a time.  She responded in a way that seemed to indicate she was tracking with what I was saying.  She said a distinct yes, for all three of us to hear.

What is most comforting to me and, I am sure, to Mary Ann is that should she qualify for Hospice Care, she will be able to stay at home to the very end.  We both dread hospital stays so much; that alone was enough to seal the deal.  Of course, there still could be need for hospital care, but since Hospice can administer IV’s at home, it is far less likely there will be any need to do so.

I talked about the DNR option.  After explaining it and the reasoning for it, I asked her first thoughts on it.  Again she said, yes.  I told her that I would check back with her another time to be sure.

Since, a decade or two ago, Mary Ann already had tearfully wished she had gotten something she could die from rather than the long protracted decline of a disease like Parkinson’s, the DNR did not bring resistance but agreement.

Speaking of tears!  I have encouraged people, men and women alike, to celebrate the ability to cry as a powerful gift from God.  I have told people that it is a sign of strength and not of weakness.  At the same time I was proud of myself that in my adult life I could count on one hand the times I had cried out loud, sort of denying my own counsel.  Well, I am now, a few weeks short of my 67th birthday, giving up counting.

Last night in the cabin at the retreat center in Oklahoma, I could no longer hold it in.  I have ministered to people for forty years.  I have watched die and done funerals for people that I genuinely cared about.  I refused to become clinical and treat funerals and the people grieving at them as just a part of a job.  I risked becoming vulnerable enough to care about them.  I buried babies, and teenagers and young adults, parent of young children, people of all ages and circumstance.  I felt the pain and cared about how they were feeling.  I ministered to people and preached at the funerals and never broke down (except once in an inconspicuous moment after preaching at the funeral of one of my best friends).  I cannot describe to you just how different it is to think about watching Mary Ann go through what I have seen far too many times in these forty years.

I want this process to stop right now.  I am not willing to lose her — but I can’t do a damn thing about it!  There is no where to which to run to get away from it.  I have a very ugly and very loud cry.  I guess not having practiced it more, I never really learned how to do it well.  I warned the kids tonight and asked them to explain to their children that they might see their Grandpa crying out loud, but not to be afraid.  I wanted them to know that it is all right, even healthy to cry, to let their emotions show.

I spent the evening the night before last talking with friend John.  I just spewed it all out, the good, the bad and the ugly.  I can trust John with the worst of it.  He can listen without judgment and never give advice.  He had gone through a shorter version of this when his wife died of Cancer — shorter, but no less devastating.  He had some very tough challenges as a single parent immediately after Sherrie’s death.  I shared a struggle with anger toward someone in Mary Ann’s closest circle who hurt her deeply.  That evening, that person and that deed’s power to turn me into someone I don’t like was lifted from my shoulders, better said, my gut.

So much is happening so fast.  This is all I will write for now.  More will follow.

If you want to write a comment about this or any of the posts on this blog, look to the column on the right side of this page, titled “Recent Posts,”  click on the name of a post and you will find a box at the end of that article in which you can write a comment.  Clicking on the title of the post you are reading will accomplish the same thing.  Comments are appreciated.

 

March 4, 2010

Hospice Report — Lisa’s Here — Construction Begins

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We met with two folks from a local Hospice program for about an hour and a half this afternoon.  The construction has begun on the sunroom.  Lisa has arrived.  Three of the anticipated events have been (are being) realized. 

Lisa came in late in the evening.  Mary Ann was in bed but awake enough to get to see her and talk for a moment.  It will be interesting to see which Mary Ann will be present with Lisa during these three days, sleeping Mary Ann, hallucinating Mary Ann or lucid Mary Ann.  It could be all three who appear.  This form of dementia is so odd and unpredictable in how it presents itself. 

The folks from Hospice were, of course, very pleasant and engaging.  The one who took the lead was Nurse Lisa (same first name as our Daughter – lest you be confused).  She had managed to get information from the doctors, at least the Cardiologist.   She had read it over carefully and was fully aware of Mary Ann’s situation, at least to the extent of what was covered by the information she had received. 

They asked lots of questions, and listened carefully to the account of Mary Ann’s current situation and recent history.  There is a doctor in Kansas City who is charged with determining if Mary Ann’s problems rise to the level required for enrollment in Hospice.  The three general problems that will be evaluated are her heart issues, her late stage Parkinson’s and her dementia.  It is one of those three that must be at a certain level.   

One understandable but mildly disappointing observation made by Nurse Lisa was that Mary Ann’s dementia was certainly not bad enough to qualify her.  Understand, I would be happy to hear that she isn’t yet far enough along to require Hospice care.  Nurse Lisa made that comment after Mary Ann got up from a nap and I brought her to the table with us.  Mary Ann was alert enough to present herself well. 

Parkinson’s Disease Dementia [PDD]  is a Dementia with Lewy Bodies [LBD].  It is different from Senile Dementia or Alzheimer’s Dementia.   PDD/LBD does not move in a steady decline but erratically jumps between severe dementia, especially hallucinations, to lucidity, or sleep.  All of the LBD Spouses in the online group I am in know about “showtime.”  People with this disease can present themselves in a way that looks and sounds as if they are functioning very well.  Later this evening Mary Ann was hallucinating almost constantly, just as she had early in the day.

One of the challenges with this disease is finding people who understand it, or educating them so that they do.  We will find out by Friday what the doctor says about the assessment of her problems and their implications for enrolling in Hospice.  Since I will be out of town on retreat, they will call our Daughter Lisa.  By the way, our Daughter Lisa worked in a Hospice program in South Carolina for a few years.  She said that there and in the Hospice programs she has checked on the Internet, a problem called “Failure to Thrive” has often been used.  That is used when there are multiple problems, including weight loss.  Mary Ann’s height/weight ratio fits well within the range of those who qualify for other hospice programs. 

Nurse Lisa and the other Hospice rep named Chris mentioned that 20% of those who enroll in Hospice, eventually graduate.  That means they get better and no longer fit the criteria for enrollment.   If Mary Ann is enrolled, we will set graduation as a goal.  While the resources and support provided by Hospice appear to be wonderful, we have a pretty effective system already and would like to extend our quality time together.  Bythe way, a recent study is suggesting that those enrolled in Hospice generally live longer than those who are not enrolled in hospice.  The LBD Caregiving Spouses online group posted that information this morning, well before this afternoon’s meeting with Hospice. 

This morning we experienced the classic frustration of conflicting medical problems and treatments.  When Bath Aide Zandra was doing the morning shower, hair washing, dressing routine, Mary Ann fainted two or three times — once she bumped her head since Zandra had her hands full with soap and hand held shower sprayer and could not catch her in time.   I suggested to Zandra that maybe I could give her the Midodrine that helps raise her blood pressure before Zandra comes to see if it will help.  Then when Parish Nurse Margaret was here later in the morning to spend a couple of hours with Mary Ann so that I could have a break, her blood pressure measured 204/100.   There seems to be no way to keep her from experiencing a low blood pressure syncope (fainting) without raising her blood pressure dangerously high.  Imagine how high it would have been if I had given her a Midodrine this morning before Zandra came.

The jury is still out on whether eliminating the Amantidine is more good than bad (see last night’s post). 

After the meeting with Hospice, we managed to get to a Lenten Worship Service at church and the meal following.  At the meal, she was willing to let me feed her.  She ate a good quantity of food.  She usually resists letting me feed her in public.  It may be that there are so many church folks there who have been very accepting and very helpful to us, that Mary Ann simply feels secure enough not to be so concerned about what they think of her as she is being fed. 

The very noisy construction crew have been doing demolition and then preparation for putting in the subfloor of the new sun room.  It will be hard to put that project out of my mind so that I can relax for the three days I will be on retreat.    The time is set for John to come to the center and spend time talking tomorrow evening (see last night’s post)

It seems like such an important transitional time for us.  It will not be clear how important it is or is not until weeks or months later as this journey unfolds.  The Spiritual Formation Group’s conversation this morning centered on the matter of  looking for past times that ended up serving as teaching moments for God to shape who we are becoming. 

I guess it is still energizing and exciting to realize that even as Geezers we are growing and  becoming more than we have been and less than we will be.  It is sort of like Adolescence without the pimples!  (Constipation instead.)

If you want to write a comment about this or any of the posts on this blog, look to the column on the right side of this page, titled “Recent Posts,”  click on the name of a post and you will find a box at the end of that article in which you can write a comment.  Clicking on the title of the post you are reading will accomplish the same thing.  Comments are appreciated.

 

March 3, 2010

Anticipation

Posted by PeterT under Daily Challenges, Family, Help from Others, Information on Parkinson's, Meaningful Caregiving, Practical Tools for Coping, Relationship Issues, Sources of Strength, Therapeutic Activities | Tags: , , , , , , , , , , , , , , , , , , |
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Connecting the posts on this blog to Facebook has brought a wonderful new dimension to this experience.  It is hard to describe how meaningful it is to be noticed by so many of the folks we have known and cared about over more than six decades.  It is easy to feel very isolated when spending most of every 24 hours inside a small townhome.  It is hard to feel isolated when reading comments of so many who wish us well.

It struck me today that it is a time of anticipation.  So many things are converging on the next few days.

  • The Neurologist okayed the removal of one of Mary Ann’s long time meds.  It is called Amantadine.  Its purpose is to reduce the dyskinetic movements produced by years of taking the main Parkinson’s med, Sinamet.  Dyskinesias are the wavy  movements that are apparent when Michael J. Fox is on television.  Those movements are not caused by the Parkinson’s but by the medication that gives basic mobility.  The Amantadine can trigger hallucinations and fainting spells (Orthostatic Hypotension).  Both are major problems for Mary Ann.  We will see if the trade-off is worth it.  We have stopped the Amantadine and we are waiting to see how Mary Ann will fare.
  • We are anxiously awaiting our Daughter Lisa’s arrival late tomorrow evening.  We both love having our children with us.  Lisa lives a ten hour drive away.  On that account it is a special treat.  It will be good for both Mary Ann and Lisa to have a couple of days of one on one time.
  • I am anticipating almost three days of solitude at St. Francis of the Woods Spiritual Renewal Center in North Central Oklahoma.  I will hike and read and pray and sleep and listen to music and look for birds and varmints of all sorts.  I will walk for hours and let the endorphens wash over my brain.  I will think about where we are in our lives and how to better deal with it all.  The reading will include devotional material, the Scriptures, a couple of books that deal with Quantum Physics and Theology. I will do each thing if and when I choose.  For a few hours the locus of control will shift from external demands to internal needs.
  • I am anticipating, assuming it works out, time talking with as good a friend as a person could have.  Many years ago John and I spent hours talking as he was going through the loss of his wife to Cancer and I was trying to come to terms with Mary Ann’s Parkinson’s.
  • I am anticipating a visit at our house tomorrow afternoon from a couple of people on the Staff of a local Hospice program.  They now have access to all of Mary Ann’s doctors, and whatever information they can gather from them.  I will, of course, have many questions.  There are certain criteria that must be met to be served by Hospice.  Actually, I would like very much to be told that Mary Ann is not yet eligible for Hospice.  This is a time we would love not to measure up.
  • I am anticipating the delivery of materials tomorrow and the beginning of the construction on our new sun room, which will become interior space in the house.  When it is done, we will be able to see from the inside of the house the waterfall project that was done six months ago in our back yard.  Since we are here pretty much 24/7, we want the best and most nurturing environment possible.  I am bummed that the project will begin while I am gone.  The weather here forced the later beginning time.
  • I am anticipating sitting with Mary Ann (depending on how she is doing) and Daughter Lisa and Son Micah this Saturday evening to talk about Hospice, especially the prospect of putting in place a Do Not Resuscitate (DNR) order.  This has been a tough journey for the kids.  Gratefully, they are committed to whatever seems best for both Mary Ann and me.

The day went pretty well today — better than I expected since she is in the hallucination cycle.  She went to her Tuesday morning group and tracked well there according to Mary, who sits next to her.  There was some intestinal activity, but since a number of the ladies in the group have served as Volunteers with Mary Ann, Eva and Mary managed to deal with the situation. While Mary Ann was meeting with hergroup, I enjoyed some time talking over coffee (PT’s of course) with the Pastor who is now in the position of Senior Pastor from which I retired.  It was a good time together.

Mary Ann wanted to go to McFarland’s, the restaurant at which we were eating when I decided that it was time to retire and be with Mary Ann full time.  I thought again how grateful I am to God that the decision was so crystal clear.  It took approximately 13 seconds to finalize that decision as I watched Mary Ann struggling to eat.  Today she struggled again.  She got nothing in her mouth until she finally agreed to allow me to feed the hamburger to her.  I had long since finished my meal.  With my help she was able to consume two quarters of the hamburger.  She had some left over Baskin & Robbins ice cream from the freezer when we got home.

Later we managed to get out to the grocery and buy lots of food, especially ingredients for Lisa to use to make some things for our home freezer that I can thaw and just pop into the oven.  That is a tremendous help to us, since I am well-known for my lack of skill in the kitchen.

Supper was another challenge, but she did get some food down.  She then ate the new two scoop B&R treat that we had brought home this afternoon.  Are we bad or what!

Tonight the dreams and hallucinations are active.  She called me to come in and said, “I am awake, but I don’t know how to get up.”  She thought it was daytime.  She had one of the dreams that she cannot differentiate from reality.  I was taking a Call (another position at a church somewhere), and we had to get ready to leave.  There was a hug and a kiss when I told her I am not going anywhere, I am for her and her only.

Well, there is no telling what tonight and tomorrow will bring, but whatever it is, we will make the best of it, grateful for the time together.

If you want to write a comment about this or any of the posts on this blog, look to the column on the right side of this page, titled “Recent Posts,”  click on the name of a post and you will find a box at the end of that article in which you can write a comment.  Clicking on the title of the post you are reading will accomplish the same thing.  Comments are appreciated.

 

March 2, 2010

Time to Accept a New Normal

Posted by PeterT under Daily Challenges, Information on Parkinson's, Meaningful Caregiving, Practical Tools for Coping, Uncategorized | Tags: , , , , , , , , , , , , , , , , , , , , , , , , , , |
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I think spending the day last Saturday while Mary Ann was sleeping, moving into and through the feelings about where we seem to be headed allowed me to listen better and and come to terms with where Mary Ann is now in the disease process.

In the phone call about the fax I sent last week, Dr. Pahwa’s assistant relayed the option that Mary Ann see a Psychiatrist to look over the medicine regimen to see if there are some better options for her.

When we talked with Dr. Pahwa today, it was apparent that the Psychiatrist option made sense if I was still uncomfortable with the Seroquel.  We would need to use a local Psychiatrist where we live (an hour from KU Med) since one of the main alternative meds demands monthly blood tests to monitor it.  I have read enough to know, and Dr. Pahwa confirmed, for the sort of dementia Mary Ann has, Seroquel is by far the better choice.  The alternative also is likely to make the fainting worse.

Here is the heart of the matter.  There is no one around this area who knows the unique characteristics of Parkinson’s as well as Dr. Pahwa.  I suppose it sounds arrogant to say so, but I would have to explain the uniqueness of Mary Ann’s complex version of Parkinson’s and the character of this dementia to someone who is a generalist and does not focus all their attention on Parkinson’s.

I know of nowhere to get better information on what to do and when in dealing with the complexities of Mary Ann’s expression of Parkinson’s.  Every time in the last 23 years we have gone to anyone other than the Dr. Pahwa and Dr. Koller before him, Mary Ann has done poorly.  She has been where she is now in some ways at least twice before, once 14 years ago and once about 8 years ago.  The first time it was Dr. Koller and the second time it was Dr. Pahwa who brought her back to a high level of functionality each time within weeks of seeing them.

While he was sensitive in how he approached it, and actually simply responded with a look that said more than enough when I said it, Mary Ann is doing as well as we can hope given how long she has been battling the Parkinson’s.  Changing meds in some elusive search for the perfect combination restoring her magically to a former place in the journey would be a very risky exercise in futility.  What might be gained is not worth the risk of what could be lost.  Those are my words, but he agreed immediately.

If we lower the Seroquel, we opt for less sleep time and more hallucinations.  Selfishly, I don’t think I could handle that result.  The two days and nights she sleeps, allows me to sleep.  The times there are streaming hallucinations already push me right to the outer edge of my capacity to cope.

It is time to accept that we are where we need to be.  This is our new normal.

We talked some more about enrolling in Hospice.  We will have a family talk this Saturday when the kids and I are together.  If Mary Ann is awake and alert, we will certainly include her in that conversation.  If she is not, I will talk frankly with her about it.  I have already begun doing so.  I talked openly with Dr. Pahwa, as we were together with Mary Ann in the Examination Room.  I talked about the DNR (Do Not Resuscitate) order that would be expected for the full Hospice program.

I will try to get someone from Hospice to come over to the house before I leave Thursday morning for three days of solitude at the Spiritual Renewal Center in Oklahoma.  I will also try to get any input the Cardiologist might be willing to give that could help inform the decision.

I mentioned in last night’s post that Mary Ann was beginning to hallucinate.  She also fainted two or three times during that first commode trip of the night.  She did not sleep soundly through the night.  There were a number of trips to the commode.  As happens when we transition from sleep days to hallucination days, she was up more than once an hour in the last half of the night.  I finally fed her a single serving container of applesauce and took her out in front of the television with the promise that she would not get up.  Then I got a few minutes more sleep, until the alarm went off, got showered and dressed.  By that time, she had, of course, gotten up and was on the floor outside the bedroom door.  She did get a scrape on her leg, from what I am not sure — there was nothing obvious that she might have hit.

She took her pills and ate breakfast in time for Bath Aide Zandra to get her showered, hair washed and dressed in time to leave for the Neurologist appointment in Kansas City.

She had pretty much shut down and moved into her head on her lap mode as we moved from the bedroom to the door to the garage.  I have never had a more difficult time physically, getting her out of the chair, to the steps, down the steps, to the car, and into the passenger seat.  I almost had to carry her.

We made it into the car.  She had her head down the entire trip to KC.  Getting her out of the car and transferred directly to her wheelchair went much better there — probably because there was no walking, nor were there any steps.  In the past, steps have been her best thing.  That is one of the  unusual characteristics of Parkinson’s.  The line of the step make it easier to get her feet to move than on a flat plane.

In the doctor’s office, she was in leaning forward mode, although not all the way to head in lap position.  She was minimally responsive during most of the time with the doctor.

We agreed to fill out an assessment that will be used in a study on the impact of non-motor symptoms of Parkinson’s — all the problems other than the ability to move arms and legs, and keep balance.  The survey took a very long time.  Mary Ann was really struggling to respond.  I am not sure how helpful we were to the study.  One interesting quirk was that while she managed to say the months of the year backwards, December, November, etc., she could not track with another request.  She was asked to count backwards from 100 by sevens.  I was glad I wasn’t asked to do that.  Kelly, who was administering that part of the survey, explained it and repeated the instructions a number of times.  Mary Ann’s first response was to just count backwards from ten to one.  Kelly repeated that it was counting from one hundred, subtracting seven each time.  She then said what is seven subtracted from one hundred.  Mary Ann answered, three.  She never connected that Kelly said 100, no matter how many times she explained it. Mary Ann always responded with ten.

Admittedly, it was hard to watch as she was asked to write a sentence of any sort, and she made some tiny scribbles and was not able, of course, to read it or say what she wrote.  She was to draw a simple shape matching one on the paper in front of her.  She made a couple of attempts, but to no avail.  Mary Ann was always very good at drawing.  She illustrated a children’s book she wrote many years ago.  She never tried to get it published, but it is very cute.

I know she hates how much she has lost over the years.  It has become just a fact of life now.  It is part of our current normal.

When we got home Mary Ann ate some thick and hearty steak soup with my help, finally falling asleep in her lemon meringue pie. She was refusing to let me help her at that point.  She napped in bed for a couple of hours, got up, ate the pie (this time letting me help), and soon headed back to bed.  Of course, I cannot be sure how tonight will go, but we are on the increasing hallucination time if her current cycle of symptom changes continues.

Today was a day in which the facts of our situation seemed quite clear. Having worked through the strong feelings about the matter last Saturday, and a Sunday morning a month ago, seemed to make it easier to be rational about the information available to us today about where Mary Ann is in this journey with Parkinson’s tagging along.  Dr. Pahwa reminded us how long our battle with Parkinson’s has been going on — twenty-three years now

It is time to accept where we are in the journey.  We don’t have to like it.

If you want to write a comment about this or any of the posts on this blog, look to the column on the right side of this page, titled “Recent Posts,”  click on the name of a post and you will find a box at the end of that article in which you can write a comment.  Clicking on the title of the post you are reading will accomplish the same thing.  Comments are appreciated.

 

March 1, 2010

A Great Day!

Posted by PeterT under Daily Challenges, Help from Others, Meaningful Caregiving, Practical Tools for Coping, Sources of Strength, Therapeutic Activities | Tags: , , , , , , , , , , , , , , , , , , , |
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What a ride!  Mary Ann was ready to get up at 7:15am today.  This time I did not ask her to stay in bed until the alarm was due to go off at 7:45am.  She had been sleeping for 36hours straight.  I decided I did not want to risk her falling asleep again for a number of hours.

I got her dressed right away; then washed her hair. She took pills and ate a good breakfast.  She let me feed her.  She did not seem to be hallucinating at all.  She was very lucid.  There was a some fainting, so after checking her blood pressure, I gave her a half tablet of Midodrine to help keep her blood pressure up.

Volunteer Elaine came to stay with Mary Ann this morning while I had my usual Sunday morning quiet time at the lake.  Elaine engaged her in conversation.  At some point while I was gone, she began reading to her, which Elaine was doing when I returned.  Mary Ann was leaning forward some, but Elaine just moved her back up regularly.  As a result, Mary Ann was awake all morning.

Mary Ann picked scrambled eggs and bacon from the options I gave her for lunch.  She ate every speck of it on her own.  By the time she was done with the small amount of Baskin & Robbins ice cream that was left from a few days ago, Volunteer Jan arrived.

This is the first of the monthly Beginning Birders’ field trips I have been able to make.  While I did not get a detailed report from Jan about how things went, Mary Ann was awake when I left and awake when I returned.  As far as I know they had some good quality time.

Jan brought food to heat for supper.  Since Mary Ann had been up all day, we decided to stay home rather than go to the Evening Service.  That way I was able to prepare what Jan had brought.  Again tonight, Mary Ann let me feed her supper.  She ate a full serving and followed it with one of two scoops of Baskin & Robbins ice cream that I had gotten for her two days ago.

You can do the math.  She ate three full meals today.  She also had part of an apple as a snack when Jan was here, and a snack of some coffee cake with Elaine just after I left for the lake.  Her body must be in shock from all the food!

If a person only had today as a reference point for Mary Ann’s health, they might wonder what all the fuss is about.  My gut has been yanked from one extreme to the other in a matter of hours.  I guess that is nothing new.  I felt good today also, knowing she was doing well.

There is a certain level at which there is frustration that today seems to make yesterday’s grieving a meaningless waste of time.   I remain convinced that feeling the feelings when they come is better than burying them, in case things might change.  In our situation, they will change.  The grieving I did yesterday still counts.  I know where this is going.  I probably know too much having read emails written by folks in the throes of the worst this dementia has to offer.  I know too much from forty years of ministering to people going through terrible times of pain and loss.

Yesterday provided some preparation that needed to be done.  There will be more that needs to be done as we move to new and still more difficult stages of the disease process.  Having gone through the reality therapy yesterday, having grieved more the anticipated losses, today is all the sweeter.  She got to have today.  I got to have today.

This morning’s time at the lake offered great entertainment in all the displays by the birds.  I read a very meaningful devotional piece in the Spirituality Journal called Weavings.  The sky was crystal clear and the air crisp.  All of it combined to lift my spirits.

There were American Bald Eagles to watch again.  I saw a drama unfold, as a juvenile Eagle spotted a Canada Goose with a broken wing, walking across a road less than a hundred feet from me.  The drama happened about 150 feet away.  The Canada Goose managed to ward off the Eagle as he tried to make lunch of the goose.  While the goose did not have the weapons the eagle had (talons and powerful beak) the goose was bigger and heavier.  Later I watched from fairly close range two Red-Tailed hawks fighting over a kill.

Then there were the White Pelicans.  They are huge and have a magnificent wing span.  Their wingspan can exceed nine feet, much larger than an eagle.  One Pelican circled around and around until it was almost overhead.  They are blindingly white (especially in this morning’s sun) with contrasting black on part of their wings.  It was quite a sight. There were a variety of waterfowl coming an going.  It was quite a treat.

This afternoon, the time with the birders at a different lake was another treat.  I learned more about identifying a few birds and enjoyed talking with other folks with like interests.  We spotted an eagle, some Mergansers, Redheads, Ring-necks and Golden Eye water birds – along with the ubiquitous Canada Geese, American Coots, Mallards and Ring-Billed gulls.

After such a good day, I must add that I just went in to check on Mary Ann.  The hallucinations have started again.  She agreed to manage a treasury of come sort and was afraid she had messed it up.  So much of the time there is nothing I can think of that even remotely connects with the hallucination or dream.  Then she fainted two or three times as we tried to get to and from the commode.  I will take her blood pressure in the morning to see if some Midodrine seems warranted.

I think I am going to get whiplash!

Tomorrow is the appointment with the Neurologist.  The report will be in tomorrow night’s post.  I am anxious to see how the appointment goes.

If you want to write a comment about this or any of the posts on this blog, look to the column on the right side of this page, titled “Recent Posts,”  click on the name of a post and you will find a box at the end of that article in which you can write a comment.  Clicking on the title of the post you are reading will accomplish the same thing.  Comments are appreciated.

 

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