Progression Two

Occasional notes in the life of a Parkinson patient & her carer.

Saturday, December 30, 2006

Chapter 67 - A Xmas Week

Typing but not posting this Xmas morning 2006. Gray & damp. Sitting in our caravan in the town where Oz was introduced to extra woolly sheep. I packed everything except the cable to my mobile so posting blogs must wait until we return home.

Last Thursday an entire afternoon in BBQ ritual with friends at our place. In consequence we had no inclination to pack the van until Friday morning when we planned to leave. Also, every thing was deposited in the van topsy-turvey, only the fridge was packed with perishables, beds not made, so fortunately she did not see inside the van before we left. I forgot – Thursday she decided to make two Xmas puddings that required my assistance to mix and were cooked in the microwave quite successfully.

In checking the van lights before leaving we found that the new heavy duty socket on the truck had broken (I had replaced it during the last trip) so after taping the plug & socket together and replacing two fuses we left an hour later than intended. Just out the gate of our village she declared “You don’t have the mirrors fitted” and of course the sodding things were in the garage at home, so I parked out on the main road (she objected to a U-turn) and walked back to the house in the heat. Fortunately for me, our friends found her in the van out on the main road so rescued me at home drinking cold Diet-Coke (yuk) in preparation for the trudge return in the heat. So I was able to return to the van my forgotten Merlot cask as well as the mirrors.

Although we knew the way, we navigated to the caravan park using my brand-new Tom Tom GO 910 GPS, a toy bought at Hardly Normal’s for a matched on-line price a few days earlier. And early last week an E-tag for the truck was delivered. In terms of high tech navigation we have arrived in the 21st century. We now find driving about the suburbs stress free, with no need to check the street directory and without wrong turnings (mostly).

On Saturday we navigated to the mountains for an early Xmas lunch. Our youngest grand daughter expressed disappointment that Santa had not delivered the present we gave her – sweet & innocent. I had some bonding with the elder grand daughter when we watched the latest Harry Potter movie we gave her (I nodded off a few times during the unfolding of the rivetting plot) and the grandson was engrossed with sketching using the pencils we bought for him. Grandmother was able to enjoy her day as grandma, playing a dice game with the kids after lunch.

Sunday: Our next door neighbour is now in a nursing home in the town up-river from the Big Smoke. When we visited her at 11am we were horrified that she is squashed into a room about 10 square metres also accommodating two other elderly ladies, one blind. Two of them sit side by side, elbows almost touching. Little space to move so it is fortunate that none are mobile.

Then a light lunch with her middle sister. After waiting for a thunderstorm to pass we all visited the family burial plots at the big cemetery a few suburbs away. Without trying, I arrived at the cemetery ahead of the brother-in-law who brought her two sisters. Proves that navigating with GPS for the fastest route can beat a local native! I took some photos of the flowers placed on the graves. As we walked back along the grassed scruffy path to the cars, protected with umbrella and raincoat, for light rain was falling, I had the sudden realisation that we were old, we were once here together when in our youth, but now our short journey is nearing its end. Cemeteries demand cloudy skies, damp undergrowth, light rain, self-sown oleander and brier, cracked concrete and decay. Opposite, I found the sight of the newer Greek graves, all black marble, at least an acre or two yet no room for weeds, flash and slightly offensive.

Xmas Day: In the van this morning, she rummages through the Xmas cards brought from home, reads aloud items she thinks will interest me. I feel guilty that we sent no letters with our “cards” this year. As we did yesterday, we did not rush this morning for she feels better when visiting to arrive at a time when her meds can be expected to allow her reasonable movement. We arrived at her youngest sister’s at 11:30am for Xmas lunch. A pleasant affair, good food, plenty of laughs, yet I felt limited in conversation even though I talked too much. The timing and duration of the meal disturbed her 2pm meds as usual. As we left at 4pm her movements were stiff, needing help to get up from the table and to walk to the truck, up a sharp gradient. She rang the mountains to say we were not up to visiting the grand kids again today; heard disappointment that we had not visited this morning to see present openings. A shame, but I doubt the kids would have appreciated waiting until late morning anyway. It is better we understand rather than be understood; but we hurt a bit. Anyway, this has been a very pleasant Xmas holiday so far.

She has stopped having breakfast so that morning meds work better. We try to have lunch at noon, although that hardly ever happens when we visit. However, she is able to sit all afternoon at table without problem until she has to rise, and then she will need assistance to turn and stand to leave the table. And seated in the truck is easy for her too but tension due to traffic conditions is very upsetting for her. GPS helps relieve these tensions. She carries the TENS machine everywhere, often applying it to her right arm should pain begin. I attach the pads to her lower back when needed in that area.

After arriving back at the van in the mild evening we walked a few hundred metres toward the town until we found an old park bench to rest upon; she was unable to go further, so we returned to the van and drove the truck down to the post office to post a few letters.

Then a quiet evening watching Xmas TV fare. That is after I found water in the kitchen cupboards. There had been a slow drip from the hose fitting on the side of the van. The drips had fallen onto the vent of the water heater, dribbled into the heater housing, beneath it, then across the van floor inside the cupboards then to drop to the ground on the far side of the van. A slight list of the van aided the dribbles to flow. A matter of playing at cubby houses.

Boxing Day: She is surprised this morning at her condition. Awoken by the 6am alarm she dozed off again until I woke her sufficiently 15 minutes later to have her Modapar Rapid, the kick-start soluble Sinemet taken in a small pill bottle of water prepared the night before. She returned to sleep as I went to the amenities block to shower, having first turned on our van’s gas hot water. About 7:20 I woke her again. She showered in the van. At 8am she called for help. This morning she was unable to dress herself. Her back was bad, the “thick” feeling in her lower back seems to paralyse her movements. Once she was dressed she asked for the TENS machine for her back. I attached the electrode pads either side of her lower spine. Fifteen minutes later she was much better. I made her a cup of hot chocolate.

Wednesday 27th: We left early this morning to visit her Aunt on the central coast. On the way she applied the Tens magic to her right hand. Half way along that long suburban street that joins the two motorways used to escape northerly from the Big Smoke I stopped to shop for a mobility scooter. A chemist had a suitable model for $1550 but the large outlet holding a large range of the machines that I intended to visit was closed well into January. After arriving at the Aunt’s late morning I found a scooter outlet where the dis-assembly & re-assembly of a $1950 model was demonstrated. I lost the pamphlet for the model when I bought some pies for lunch. We departed late afternoon, & without visiting others in the area, returned south to the van park. The congested driving all day gave her a lot of white knuckles while hanging onto the grab bar on the dash; tiring her. She did not wait till midnight before going to bed.

Thursday 28th. She slept through the 6am alarm this morning. The noise woke me; tempting to stay in bed; superior will-power made me get up to wake her for her first pill of the day. Then after I switched on the van water heater I went for a shower in the ablution block. At 7am she showered. Some time later she called me. She had both her pants & bra half on. “My hands aren’t working!” I helped her finish dressing. Sometime around 10am we drove to the nearby shopping centre to do a little impulse buying. We successfully disposed of nearly $200 then we discovered her favourite franchised dress shop. Back at the van park we found one of her sisters waiting; then sister #2 arrived. And brothers-in-law. A pleasant gathering in the sunshine beside our van. The van park management had told me that the local RSL had an excellent Chinese restaurant so we feasted on a banquet lunch there before returning to the van to chatter away the remainder of the afternoon. In all, a very enjoyable day. After our guests had gone she needed help to change her clothes then she went to sleep on her bed. I had to wake her for 7pm meds after which she slept again. By 9:30pm she was restless, needed to walk a little. He ankles were swollen, Her arms & breasts itched. I propped her with pillows on the bench seat in the van so that her feet were raised. Her face was sweaty, needed the fan. She needed help to dress for bed at midnight.

Friday 29th: At the alarm for her 6am meds she needed help to rise for the toilet. When I returned from showering in the ablution block she said her legs had been aching "in the middle" since yesterday. She was very tired although she had slept well. By 7am she was unable to stand so stayed on the bed the wrong way up & slept. At 8am we decided perhaps we should stay another day (we were due to leave today; we had arranged to stay another day to meet with friends for lunch but that had been cancelled due to his ill health). She decided to shower at 8:30am after which she needed drying and dressing. By 9am she was keen to go home; I think she wanted the safety and comfort of home. By 10am I had packed, hitched and we were on the road. Home at 12:15pm, she was in bed asleep within a half hour. I woke her at 2pm for meds. Although at first she had been hot, she later needed the doona for warmth. She rose with a headache across the back of her head at 4:20pm without the meds having kicked in. Around 5pm she was able to help me navigate the van into its shelter. Some mushrooms on toast. By 10pm the headache had lessened, although she refused to take anything; "I hate taking pills!" she says. Her midnight meds were taken half an hour early because she was too tired to stay awake any longer. During the night diverticulitis problems disturbed her so she walked the floor for awhile.

Saturday 30th: When she woke for 6am meds the headache still bothered her. At 8:30am she showered and dressed herself; well almost. At 10:30am I convinced her a couple of Panadol were needed. A friend phoned at 11:30 when I found her in bed asleep. By 12:30pm she was awake, diverticulitis still a bother. The headache was gone by 3pm yet her head felt "thick".

I wondered whether Thursday's Chinese banquet had been heavily loaded with MSG. She, browsing, has discovered the negative effects of MSG on meds. The coincidence is strong, yet in reading back through these notes I see that she was experiencing some bad times during this enjoyable Xmas week. My view of life would be much brighter without my little notebook & this blog; roll on "old-timers'". Maybe we need to pay more attention and read food packaging labels more carefully. If only we could identify the causes for "good days" and "bad days" life might be normal again. I am concerned that she has complained several times now that her hands are not working; this is a recent development. Her feet often ignore her mind, we have come to expect that.

Sunday, December 17, 2006

Chapter 66 - Surprised by an Image

A few days ago I decided I had better scan some old photos borrowed from her Aunt; we hope to visit her again in a week or two. Toward the end of the task I discovered a large photo of a young girl, a hand-tinted studio photo of a 17 year-old taken almost 50 years ago. She is looking into a mirror, so her face is seen in reflection. Blonde hair, small red bow-shaped lips and a little rouge on the cheeks. Her dress is shapely and has vertically striped panels of small blue flowers on white. The dress always reminded me of traditional wallpaper, although I am sure I never suggested that at the time. The sleeves are short, with small cuffs. She wears a small bowl shaped hat & white gloves (typical of nice girls of the time). We discussed when the photo was taken; we concluded in the first summer we knew each other. It seems she wore it to the wedding of a work friend who had been pursued across country from WA by an estranged intended who caught up with his beloved in NSW. There is no recollection of who the friend was. I found out years later that the white gloves were often used to hide bitten fingernails on those occasions that I was able to catch the same suburban train home from work.

Last weekend we drove to our friends' place on the northern side of the steel city in substitution for the birthday party we missed a few weeks ago. On the way we detoured to an outlying southern suburb (once a country town) of the big smoke city where I booked into a caravan park for a week over Xmas. For the first time in years we will have a Xmas holiday! The anticipation excited me at the time but now I'm less enthusiastic. We intend to visit lots & lots of friends & rellies that may have gone elsewhere for their Xmas holidays. Anyway, we had an enjoyable weekend, staying overnight, even though she was worried about the slope of the street, the front yard, stairs in the house, no hand-holds in the toilet & shower and we had to sleep together on a fold-out divan. All things that do not bother a well person, or for that matter, a person once young enough to wear white gloves.

An average week. Some mornings she needs help after showering with drying & dressing. Sometimes her meds fail to kick in. We continue to have our main meal in the middle of the day in order to avoid upsetting the meds. Interestingly, meds & food conflicts are a hot topic in the PD forum I subscribe to.

A visit to her Caring Physician went well, although he was concerned that her use of a bidet (for that was her present that I made oblique reference to some chapters back) may encourage the UTI she has been taking anti-biotics for and he described the female plumbing issues to illustrate his point. I had not thought of this at all, instead being very happy her other problems in that area had been resolved. We will need to take care.

At our monthly PD Support Group we demonstrated the use of our new toy, the TENS machine, to relieve pain. Several people were very interested. Lunch in the club afterwards fitted in with our meal schedule.

Our weekly shopping had been delayed for about a week until this chief cook & bottle washer had almost run out of the where-withalls, so on Friday at the best of a bad time we confronted the horrible, ugly throng at the supermarket. As usual, she had to pass through the checkout to find a seat, of which there are not enough, so she had to stand most of the time I flexed my biceps unloading & re-loading a large trolley.

She was not capable of church this morning, having returned to sleep after her 6am alarm without taking her kick-start Madopar Rapid. So I stuffed & labelled envelopes with our home made Xmas cards that she completed a few days ago. Tonight she declined to go to our hall to attend a Xmas service. A couple of friends phoned for long chats today & another called.

Friday, December 08, 2006

Chapter 65 - Electronic Miracle

At 9am this morning she sits in her chair after combing her hair, gives me a handful of of shed hair. Her feet extend almost straight shaking, heels not on the floor, her hands wobble gently and her lower lip trembles. She had washed her hair under the shower then needed help drying & dressing. Although recently she has needed less help but perhaps I'm growing accustomed to the routine and don't notice. Her bra clips have caused most bother because doing that female thing of whipping hands behind between the shoulder blades has given her pain. The pain may now be a thing of the past.

A few weeks ago a neighbour showed her an Electronic Nerve Stimulator for T.E.N.S. therapy. I was born a sceptic and immediately doubted the claims of this type of therapy to relieve pain. Witch-doctoring cods-wallop. Anyway, I checked with our favourite on-line pharmacy to discover they would send me the top-of-range model for $145 (rrp about $180) with free delivery. I couldn't refuse a bargain like that so a few days later an Omron HV-F128 was delivered. Neither of us really wanted to initiate the use of the thing, maybe electrocution was a non-advertised side effect? (unlikely since it ran off two AA cells) This last Tuesday, just before we intended going down town to buy some photo frames (to hold likenesses of beautiful & handsome grandchildren) she complained of the pain in her right arm from her thumb to well above the wrist. OK, time to experiment! Sticky pads attached above & below the wrist. Select "Arm", "Soothe", turn on & crank up the volume control. Above a level of 4 she felt discomfort, so we wound it back a bit. The machine only runs for 15 minutes at a session so we waited patiently. As I removed the sticky patches I looked for burn marks (as one would see on the bodies of undesirables in the "land of the free"), saw nothing and she said "The pain is gone. Look, I can wriggle my fingers. Although there is a twinge when I move my thumb like this." So off we went down town to buy the frames. We have been "doing" her right arm morning and bedtime for the last few days. Although this morning after showering she was very stooped, a thick feeling in her lower back, yet no pain. Partially dressed she lay on her stomach on the bed, I attached the pads on the rear right side of her waist and set the machine for "knead massage". At completion she said the thickness feeling had gone. A little while ago as she walked past my dungeon door, saying "Look, I'm walking upright!" Encouraged by our success, the neighbour has begun using her machine. She had not used it, having only told us of its benefits, not verified in her case.

What else has happened to us since the last post? A revised report for her yearly CT scan of her kidneys stated that she had another cyst on her liver, rather than a "normal" gall bladder that was removed 20 years ago. One shadow on a scan looks much like another I suppose. In the process of this yearly check-up our GP detected a bladder infection so now she is taking a couple of courses of anti-biotics as well as regular Avapro since he says he trending blood pressure readings need lowering. Her PD meds are performing differently this last week & she suspects the new pills may be the cause. Probably not.

Her embroidery activities have lapsed after she hooped but not yet stitched a 2007 calendar which will need 3 hoopings. However she put in several days' effort preparing our Xmas cards this year and sticky address labels for them. This year we decided to attempt the el-cheapo by printing our own cards on pre-formatted paper. Unfortunately, the costs of the paper, printer ink possibly is no cheaper than buying the average "snow & tinsel" card. I wonder why we maintain this pretence inherited from the northern hemisphere?