Wednesday, August 13, 2008

The Envelope, Please!

Today we actually had progress in several directions, including, yes, a verdict which made other decisions fall into place. In the nick of time, too, because I am exhausted and overwhelmed.

A diagnosis that had been hinted at and was in the back of my mind even though every test indicated that her heart was "fine," has been confirmed. My mother’s feet have been swollen, she’s tired, she would have fits of confusion, then clarity, etc. Today they officially declared it congestive heart failure – not to her, but to me. They wisely decided she wasn't the type who needed all the details. She has some fluid in one of her lungs, so that is going to be drained. Then it will be back to the nursing home. I am not happy to have this diagnosis, of course, but I’m glad to have A Diagnosis – at last there is a name for the weird assortment of things happening to her, and that, in turn, makes her appropriate level of care a bit easier.

I had drafted the cancellation letter for the ALF yesterday, but didn’t send it, because remember, just three weeks ago the staff at the nursing home was all upbeat and sure she would be able to return to assisted living, and nobody had said that this downturn is likely to be permanent. Today the ALF's director called me, and said that she’d visited the nursing home yesterday to follow up on some of her residents who are there for rehab, and talked to the staff, and everybody is in agreement that she is back to being onery and refusing PT and losing ground independence-wise, and is not going to be able to live independently anytime soon, and I should give up the apartment. So I faxed the letter. This weekend I will rent storage and a UHaul, and next week Girl and her friends will move Girl’s furniture to storage, and then go to ALF and move grandma’s stuff to storage too. Before they go move the big stuff at the ALF, I will spend Saturday packing up clothing and odds and ends, and move the small pieces that will fit in the Subaru. So another weekend is about to be shot to shit, but I feel oddly relieved that decisions have been made and we have a plan.

I talked to my mother this evening, she was not nasty at all, and she sounded calm and reasonable. Maybe they adjusted her meds. I will be there for her, but at a safe distance, for my own sanity. I’ve been feeling utterly overwhelmed and exhausted lately – can’t imagine why – and not sleeping well. I am officially on the brink of losing it. Tonight I will be in bed by 9, I will watch TV and be asleep by 9:15. I've been waking up at 4 a.m. lately - which is a whole half hour earlier than the clock. Yeah, I have the clock set for 4:30, because my schedule since May has made regular exercise highly irregular. I'm back to doing 30 minutes on the elliptical trainer, which will NOT be going to the garage sale, thank you. Getting up that early is fine, but I do have to back up the going to sleep time accordingly, at least on weekdays.

In terms of sheer, grinding intensity and endless things to do, the last few months have been right up there with my husband's last six months, and there is no end in sight. But this time I have the added touch of a new job that takes up 60+ hours of my waking hours, and health concerns of my own. Getting up to exercise is a necessary part of taking care of ME.


carlarey said...

With all you have gone through, you are probably already on top of this, but be sure you have a DNR order on file with the nursing home.

It sounds callous, but we all know how this will go. Take care of yourself, because you and your kids are the ones who will suffer if you don't.

Catherine said...

She's still lucid, she will not sign a DNR. She won't even do a living will. Seriously, she screamed at the last nurse who asked. I have health care POA, so if she is not lucid, I sure as hell will authorize the DNR. This is my third time down this path in the last 5 years, and if I am ever at that point again (been there, didn't even get a lousy t-shirt) I am confident that my own kids would do the right thing for me.

Catherine said...

Correction, this will be the 4th time, but in the 3rd round I was the one in the intensive care unit. Doesn't count as my call.

dragon knitter said...

my mom was diagnosed with CHF last fall (at thanksgiving, nonetheless!). it's definitely a livable condition, and with her being in the nursing home, they can manage her diet very well. be prepared for more bitching about the food though. sodium needs to be 2000 mg (some say you can fudge up to 2200, but my mom tries to keep around 2000), which will make her food taste pretty bland to start. this lady sounds like she'd bitch, so be prepared.

my mom's biggest problem after the diagnosis was a recurring skin condition, because her meds dried her out so badly. we've finally gotten that one whipped (although winter will be the test). good luck to ya, catherine, i definitely feel for ya

Catherine said...

My father also had CHF, so I know the drill. She's definitely slowed down, but with proper management she may continue to complicate my life for years. ;-) Which is why I'm as casual as I am about it - I can SEE she's sick, but it's nice to know what we're dealing with, and the diagnosis combined with her lack of cooperation with PT also made the "where should she live?" decision for me.

Janet said...

Does she know that she won't be going back to the ALF, and if so, will that cause more problems? It seems like you just moved all that stuff in there. You're getting all kinds of exercise moving boxes! But still, good for you for getting up so early. Amazing.

I'm relieved for you that you finally got a diagnosis--I just wish they would've been a little speedier about it.