Am I repeating myself?

At the risk of repeating myself, I am looking at what has happened today much as my mother does - as if yesterday didn't happen.  Normally I would be methodical, careful, thorough, and go back to see what had been discussed before.  I'd want to know how she was that day and also how I was that day.

Today, I just want to talk about watching her slip from me.  And actually, today wasn't like other days.

I hurt by back a little over a week ago.  I was doing no more than shaking out a dog bed that I'd washed;  I wanted to even out the padding that had bunched up from the dryer.  I did no more than raise the pillow up and shake it, but as I shook it I swayed by back just so and once gain hit the point of weakness that started when my son was very young .. and worsened by falling flat on it while hiking across an icy patch with the same son several years ago.  I didn't just sort of tweak it out this time, though.  It was so painful that not knowing how serious it had become over night, I stood up out of bed and nearly passed out from the pain.  I was nauseous and broke out in a cold sweat.  I did not attempt to do any walking or standing again without support to pull myself up so absolutely no weight was placed on my spine of any sort.

The result - I was not able to care for my mother.  Gary did that in the evening.  Access Alaska and FRA(Fairbanks Resource Agency & Adult Day Care Center)  came through with coordinating her respite care, so I was able to start a new person for evening care.  We now have morning and evening care, but most of the information I was getting was from Pam, her morning PCA, and  Gary.  But I was not sure I was hearing of anything different.

"She is confused this morning" ... yes, much like she is every morning
"I find her curled up in the morning" .. yes, I have seen her change positions recently.  She sleeps more with her head on the pillow near the wall so she doesn't have to schootch down into the covers.  Is this different from that.
"She has a cough." ... yes, she does have a little one, but her nose is not running at all and there is no congestion or phlegm.
"She complains of her legs and back hurting" ... yep, we took her in for xrays due to her hip, but nothing was amiss.  I wonder if something is worsening.
"She is not eating much for breakfast."  ... hmm, I've noticed she is not eating much at night, but they say she is eating well at FRA.

Those were the reports during the week. Then on Friday, when Gary brought her home, he told me that the care givers at FRA said she was very weak and they had to help her get up.  He told me that he could barely get her into bed.  They mentioned a cough.

So he attempted to feed her.  She didn't eat and finally was able to get to bed.  She slept most of the next day.  I told him that if she worsened, I would call the doctor on Monday.  I don't know why I didn't want to take her 1st Care, our emergency care facility, over the weekend.  I think it was because I didn't know what to tell them.  I didn't really have much to go on except she was not well, but no real symptoms.

This morning, I again stayed home with my back.  It is better - still painful, but I can move on my own and get out of bed without the support of the walker.  Gary stayed home too.  He worked two 8 hour days over the weekend and was beat.  I got a call around 11:00 am.  Maria was very worried about Mom.  She appeared to be in pain, very tired and was complaining of lower back pain.  She thought she may have at bladder or kidney infection.

That was what I needed to hear.  I had something in my head that thought she could have a UTI recently.  I don't know why.  There has been no blood in her urine, nothing I could pinpoint, but something ... something.  I told her that Gary was home and I was calling her doctor to get her into TVKC today.  Then I called the clinic.  I told them what I needed and, of course, heard nothing back.  I told Gary to go get her and take her to 1st Care.  Then I called in to see what had happened to my question and it had been referred to the on-call nurse.  They wanted me to talk with her; I did and she agreed that taking her to 1st Care was the best choice now and she chastised me because I hadn't taken her temperature.

I thought, does it matter if she has a temperature or not?  She is in great pain, weak, isn't eating, and sleeps all day.  What in the world could that information provide ... and besides, her temperature is always below normal.  I would have to tell them it was 98F, but that really meant a fever of 2 degrees.  Thermometers are overrated in my opinion.

So, Gary gets her in and I waited for his call.  I waited for his call. I waited.  I waited some more.  Finally I called him.  They had blood tests and x-rays, but couldn't get a urine sample.  He passed the phone to the doctor.  Dr. Day mentioned she was dehydrated and this could be the a strong factor in her symptoms.  I said she had Gatorade at FRA and they made sure she drank at least 20 ounces each day. "Ah," he said.  "We can't get a urine sample.  She is resistant to giving us one.  Maybe she doesn't need to pee now.  We could do a catheter, or you could do it at home."  It sounded like he favored this approach, but I told him I could not be relied on to do it well since my back was still sore and I could not bend quickly.  And, in the back of my mind, I was becoming reluctant to delay her treatment.

I asked to speak with her.  I told her that we were trying to help her.  I asked if she could pee.  She said, essentially, that she wasn't going to go pee just because they wanted her to.  Her natural stubborn nature was in full effect.  I reminded her of how much she sick she has been feeling and how much pain she was in.  I told her that they needed to see if she had an infection and needed medicine.  Giving urine was easier than other ways.  I did not get much response and gave them the go ahead to use a catheter.  I cringed at the thought of the pain it would cause her.  I was distressed, but I reasoned that if it were not a UTI, then we needed to eliminate it rather than treat it as if it were.  We needed to find out why she was in so much pain.

Gary called me shortly thereafter to tell me she had complied with their request and she had a UTI.  He heard them in the bathroom thanking her for peeing into the toilet pan.  I think we were all enormously relieved that she cooperated with us rather than having to subject her to more pain.  Previously, I'd already okayed them giving her fluids intravenously for her dehydration.  I felt that as sick as she was, the chances of me getting her to drink at home were slim.  They gave her an IV drip for over an hour.

I called her afternoon care giver to tell her she didn't need to come because we didn't know how long it would take to get medications, etc.  Mom came home with a hamburger, fries and a coke she'd requested while at the clinic.  This is not what she usually prefers, but Gary decided to run with it.  She drank that coke like there was no tomorrow.  In between long draws through the straw, she munched on french fries.  I even got a few bites of hamburger into her before she'd had enough.

I gave her the first pill of seven - one each day because elder's livers process through the medication more slowly and it would be in her body for 24 hours.  Although I'd told the doctor I could not bend, I managed to bend enough to get her into her PJs and into bed.  It hurt for her to bend.  It hurt for me to touch her legs.  It hurt to straighten her out so she was not bent over once in bed.  It hurt for me to bring the blankets up over her.  But eventually I got her situated so she was comfortable.  She watched me for a bit.  She wasn't really sleepy enough to drop off immediately, but she was tired - very tired.

I am fortunate to have morning and evening help and I am fortunate to have a husband who will go the extra to help care for her.  But I am the one who monitors her the most closely, me and those who see her every day at FRA.  Not being able to care for her at the same time she was getting seriously ill made re-emphasized her dependency on me and her vulnerability.  It is not the first time I have considered the possibility that she would get better care in a facility than here in her apartment.  But it is the first time that I could see how clearly her lifeline is depending on my ability to watch over her - and me more than anyone else.  When I wasn't able to focus on her, she wasn't cared for as quickly as she needed.

Would it be better in a home where a few people have several to watch?  Maybe.  If they are as caring, compassionate and knowledgeable as Maria (along with Wilma, Miriam, and Sharon) at FRA it could be.