Saturday, May 28, 2011

Getting bad

The last few weeks have me scared. Two visits to the VA ER in as many weeks, and he's just getting worse. The ER trips were his idea, so I know he was hurting . The first one was Saturday  two weeks ago. He was having acute abdominal pain and, it turned out when we arrived, a fever. They kept him for two nights. Me they kept for one, on a gurney in an exam room. That way I was accessible to sign permission paperwork if they needed  to operate. Also they were concerned about me trying to drive the two hours to get home at 4 in the morning.

Two days later, after multiple tests and no food, just a glucose drip, they still didn't know what was wrong but he wasn't hurting, so they finally fed him to see if he could eat without ill-effects. When he not only ate it enthusiastically but it caused no pain they sent him home with a bottle of antibiotics for the infection causing the fever, apparently connected with his gall bladder.

During the follow-up with his gastroenterologist everything seemed back to 'normal' and he was even given a scrip for a new sleeping pill for his chronic insomnia.

The day before he was due for the follow up with his primary he was once again in pain and so we went off to the ER again. This time I had a few minutes to call ahead so they had his records pulled and appropriate doctors on standby.. They appreciated the courtesy, since it gave them time to prepare before we arrived.

This time I was able to head for home by 2:30AM while they admitted him. Two more days of nothing to eat because this time the ultrasound had them fearing a blockage in the intestine. Finally they determined that he had simply managed to pass a gallstone, on his own and probably before we even got to the hospital. The pain that sent us there had probably been that passage. No fever this time, no infection. Nothing new to deal with - just a formerly discontinued pill added back to his regimen to help him pee, and another adjustment to his diet. (sigh)

He was already restricted. No alcohol of any kind - a no-brainer, since that is what destroyed his liver in the first place. Low sodium for his blood pressure - easy - we don't use salt much anyway . Low protein to protect his liver - a little tougher since he was raised on meat and potatoes. Happily I had been widening his acceptable food range for years, so it could have been worse. Now, however we also have to go low fat, particularly the high cholesterol type, to avoid triggering another gall bladder attack. He does enjoy the occasional greasy slice of pizza or a hotdog from the local vendor (yuck), but when I described the sort of foods I already customarily serve him - the primary oil I cook with is olive, and he's almost vegetarian already -  they approved. So at least I seem to be doing my part in keeping him healthy.

I do feel a tiny bit less guilty about some of his falls now. He needed assistance every time he had to go to the bathroom, which with his meds is approximately hourly. Even with a professionally trained nurse or orderly helping he managed to take a nasty one, hitting his head on the tiles. Nothing tripped him; as he put it 'all of a sudden I just went down'. They were all set to take him for a head scan but apparently decided he wasn't damaged.

The scary thing is that I've been watching him, observing patterns, and they don't bode well.

When he eats, using the utensils with big rubber handles the VA provided, he does everything with his left hand. That is his dominant hand, but he used to use his right for things like helping to cut food, holding the edge of the plate or pushing food with a piece of bread. Lately it just lies there.

He had been having trouble writing - even unable to sign his name. I made him a printout of the alphabet, like back in grade school, as a guideline to help him relearn. His handwriting did improve a bit with practice, but he only gets through his first name and the first half of his last before he forgets how it goes and I have to help.

Getting up for a middle of the night potty run is never easy - that's when he takes most of his falls - but tonight was scary. He went down almost as soon as he got off the bed, but needed to pee so badly he didn't want to bother trying to get to his feet, refusing any help - he preferred to crawl on all fours. I gave in in the interest of keeping the peace, simply standing close by to help if he required it, however I noticed that his right arm wouldn't support him and his right leg seemed to not cooperate either. I also had to help him aim his butt when he finally made it to the bathroom, or he would have shat on the tub bench instead of in the toilet.

I'm really afraid he had another stroke at some point and has now lost still more of his already limited physical ability. :-(

If he hasn't started improving by the follow-up with Gastro on June 1 I'm going to ask that he be tested. If he is going to require round-the-clock assistance I am going to need help, or he is going to have to live in an assisted care facility. I can't run the business and be full time caregiver at the same time. Thank goodness the powers that be determined that yes, he is completely unemployable, and he has been bumped up from 50% to 100% disability. That should guarantee good care wherever it is going to happen.

Another bit of good news is that the new sleeping pill seems to work. Even though he slept most of the day away yesterday, when I gave him his evening meds, including the newly arrived sleepy pill, within an hour he was out like a light (at about 11PM) and seems to have slept right up to 4:30AM when he needed to go potty. Once that ordeal was over and he was back in bed I held his hand and he fell back to sleep quickly.

Wish I could say the same for myself. After tossing and turning for 45 minutes I gave up in favor of updating this. So here I go, into another day on 4 1/2 hours sleep. Oh joy. Sleep deprivation is such fun.

On top of all that, I had no sooner sat down to take a leak a few minutes ago, when the phone rang at 6:45AM!! It was the woman who had been beaten up by her spouse. She's doing much better, and has been looking after  the cancer guy's dog while he is in the hospital with diverticulitis (yep, it's been a busy week). She had managed to lock herself out of her own room and needed to get ready for work.So I used my key ring to let her in.

Now it is 7:15 - no hope of further sleep, and it promises to be a real warm one, so I need to get busy potting up my newly acquired plants. I may have had to cut way back on the garden this year, but I still need to grow some of my usual, for decoration and food. So lots of tomatoes, basil, one eggplant, and a whole bunch of petunias and geraniums.I'll throw a bunch of nasturtium seeds into the mix, and maybe add some other plants later, but this will do for now.

The room renovations are 2/3 done, but clearly not to be finished today, so the big holiday weekend is a bust. Oh well, at least they will be finished in time for summer business. The inspector checked the electrical work yesterday morning and signed off on it, so today the sheet-rock starts going up. Once that is done and painted we call back the electrician and plumbers to finish hooking everything up and I can add shelves, stock the flatware and plates etc. I already have a table and chairs for one room, and with flea market and yard sale season now in full swing, finding a second set should not be too difficult.

I'll also be getting queen size beds - one per room - to replace the two doubles currently in each. I can always bring in a rollaway if someone needs extra bedding for a child. Two beds were going to be too much for the rooms now anyway. with almost 1/4 of each room now kitchenette. Most folks prefer queen anyway, so that's the way I'm going. It will also help discourage families with multiple kids - a plus, since historically I get less trouble with dogs than children.

So a bit more work - maybe a weeks worth, and voila' - mini-efficiencies. Small steps to self sufficiency. My personal art room will get done eventually, but right now there is simply not enough hours in the day or energy to worry about that. Soon, but not now.

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