Progression Two

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

Sunday, October 21, 2012

Chapter 267 - A Bad Patch

My head is thick this morning, jet lagged by helping her out of bed 3 or 4 or I don't know how many times last night for her to sit on the commode beside her bed. She says she has no pain yet her left leg throbs in several places. But I am way, way ahead of myself.

After writing my last post on Thursday 11th the GP called (or the receptionist) for her to see him that afternoon. He proposed she has cortisone injections and in the meantime prescribed Durotram since the Panodol Forte gave her little relief. The CT scan of a few days ago showed two disks, at L4 & L5 I think, showed thinning, more so on the left side than the right.

So that night she took a Durotram at 2200 before going to bed; well not actually bed, since she sat in the wheelchair all night. I talked her into taking another Durotram at 0230 Friday morning to speed up the pain relief, and that was wrong because the fine print says one a day, although I am sure the GP said she could take two.

At 0700 Friday she attached the TENS machine to her leg as well as her pillow which vibrates (battery powered). She then got into bed, sleeping until 1000 when I found her sitting on the side of her bed, head drooping, feeling whoozy. Commode then back to bed asleep.  At 1430 she rose, made herself a chai latte, had a piece of cake and then fell in the kitchen without hurting herself; she she hadn't felt dizzy, just fell reaching for a biscuit container. By 1545 she returned to bed, unable to stay awake. At 1540 I woke to to ask whether she had made an appointment for the cortisone injections; she hadn't so I rang, to be given an appointment for the 29th October, since the injections had to be given by a special doctor using a CT scanner. Between 1900 & 2000 she had pasta & ice cream with cake before nodding off. So at 2045 she returned to bed. In pain all day. At 2145 another Duotram because the fine print says to take a tablet at the same time each day. At midnight she woke, problems removing her incontinence pants to get on the commode, needed help to return to bed, and I made a note in the diary that the whole procedure took an hour. Because we were both loosing track of what was happening, the sequence of events, that I from this day I began making notes in the diary, although rather disjointed & failed to include some things I'm sure. Now that matters a somewhat resolved I have discontinued this, it becomes too irritating to both of us, even though being able to review the sequence of events can almost be comforting.

Saturday 13th October (my scribbled diary entries)
0100 Into bed
0545 got herself up but needed help onto the commode (near foot of bed)
0610 PD meds
0620 Two Panamax for leg pain. Leg out of bed resting on commode lid.
0645 Sitting on side of bed
0800 Showered herself sitting on shower chair, dried most of herself
0815 Dressed herself
0835 Tried doing stepping on Wii, only 220 steps managed
h several pauses, leg too painful
1030 Late with PD meds
1100 Two Panamax
1215 Soup for lunch
1230 200 steps on Wii with one pause
1320 Falling asleep, says top of head tingles (now says this has been so all morning), mouth now tingles. Unable to complete knitted "butterflies" without making errors, usually takes an hour, now longer
1330 BP laying on bed 147/88/70. Seems dreamy, not quite with it
1400 Awake, loo for both, completed by 1410 but waiting seated for awhile.
1425 In wheelchair in lounge room BP 112/77/50
1430 Rocker under left foot became uncomfortable, asked for pillow
1435 PD meds late
1450 Wheelchaired her to loo
1545 Feels a lot better, still in lounge room in wheelchair. Rang Bowen practitioner in town to the north, appointment for 2PM on Monday
1645 Still seated in wheelchair  in lounge 145/95/67, then wheelchaired her to loo. Attempted to walk but unable
1800 Heated a frozen dinner for her
1830 PD meds
1945 Walked in pain with walker to loo. One Durotram
2215 loo then bed
2245 Heat bags on legs
2345 Three loo visits in last hour
2400 PD meds, commode. Left leg pain all day

Sunday 14th October
0020 Commode
0335 She says 8th use of commode, I was asleep, pain not too bad
0500 Asleep, she kicked the commode at the side of the bed, contents spilled, I cleaned the carpet. She was unaware.
0600 PD meds
0850 Rose, loo, sgowered using chair. Pushed trolley to loo
0930 Breakfast seated in chair at TV
1000 PD meds
1130 -1230 She supervised some washing, I hung it on line
1245 Lunch
1420 After talking to friend on phone she feels sweaty. BP 138/88/71
1515 Feels OK not sweaty or cold
1610 Called from loo, needed help pulling up pants, sat in lounge room, needed a biscuit
1830 Meal, then dozed in chair
1915 Fell while reaching for the trolley. I lifted her with the wide blue belt, she says there are no pains
2215 One Durotram
2225 To loo
2230 Into bed. There has been no head tingling tonight. Left leg pain all day

Monday 15th October
0120 Woke me for help to get onto commode. She has been cutting the incontinence pans so that she is able to remove them easily. Yesterday I ordered a new supply plus winged pads to be used at night for ease of removal
0530 Woke me "yelping" loudly, said a large cat fell out of a tree. Needed the commode. first time since 0120
0800 Rose, walked to bathroom, emptied the commode, loo, at laptop first time in days
0830 Still at laptop, jam on toast for breakfast
0910 showered seated on chair
1230 Left for Bowen appointment
1330 Arrived in town early, waited in vehicle
1350 Wheeled her in walker to steps at house, she had difficulty stepping to verandah, into therapy room
1440 Walked from therapy room to vehicle, although she stumbled & almost fell  at verandah steps (I caught her)
1515 Back in our town she remained in vehicle while I shopped
1600 At home she has walked around stiffly, much less pain
2130 To bed
2230 rose for loo, called me help, shuffles along, some pain
2355 Needed to go again, so used commode. Some time last night the stitching on her satin sheet caused her discomfort so she removed it. Tonight she needs another one on the bed.

Tuesday 16th October
0010 Commode
0410 Commode, woke me by pulling it along the floor
0510 Yelling out, talking in sleep, woke me
0700 Coomode
0900 Woke
0910 Found her on commode, unable to rise, helped her walk to the loo, no pain initially then some in hip, remained on loo 10 minutes
0925 Shower on chair
0950 dressed, minimal pain but legs won't function, fears falling, pushed walker around table 3 times then brakfast of bread & jam
0955 A little peddling while seated
1005 Walking around table with walker, then out on patio  but had to sit down , pain in left hip & calf, drinking a lot of water
1025 Needed a bowl of water in which to clean her teeth, unable to do that in bathroom. Rang Day Respite to say she was late
1030 Wheelchaired her to the garage. Sat in vehicle while I bought Panadol Osteo at chemist (friends recommended these lower strength pain killers rather than the stupifying Durotram)
1100 Took 2 Panadol Osteo
1130 Wheeled her into Day Respite
1630 Wheeled her from Day Respite
1645 At home loo for both
1715 A little seated peddling
1740 Two Panadol Osteo
1800 PD meds
1930 Attempted walking around patio but pain prevented more than a few steps
2030 To bed

Wednesday 17th October
0215 Commode, she says this is the 4th time since gong to bed
0415 Commode, needed help
0600 Commode, needed help, PD meds & two Panadol Osteo
0645 Commode
0730 shower on chair
0945 Wheeled her to the garage, we drove to the club up the 4 lane to have birthday lunch with the Ugly Sisters. Wheeled her into & out of the restaurant from the car park
1200 Two Panodol Osteo ( I didn't always record her PD meds)
1600 Home again & wheeled her into loo. NOTE: Did not need the loo between leaving and returning home!! Books I had ordered for a neighbour arrived, additional copy, "Body Reflexology" for her as well. she read parts of it, began pressing pain points
1800 Two Panodol Osteo
1840 Found her asleep on the bed
1845 She had been pressing pain points & came over very tired
2200 Tremors bad, went to bed, PD meds
2350 To loo, stepping on toes although no pain

And so it goes on. She relies on the commode but lacks confidence to get out & return to bed, although the commode is only positioned a pace away. I think she woke me at least 4 times last night, today I have the enthusiasm of cold excrement, am irritable and tired. She surprised me by showering without requiring the chair, mopped out the shower & dressed without needing assistance.

She is presently seated (mid-afternoon) in a comfortable chair in the lounge room, reading a book, her left leg crossed over her right. When I tell her she must not cross her legs because that causes back & leg problems she says doing so gives her relief in her left leg. Then we have a debate about whether dull aches are pain or not, at the moment it seems she has ache area on her lower left leg.

Against my better judgement I went to our computer club yesterday afternoon, rang to check on her, she had felt tired & was laying on the bed. I can't remember whether she was there when I returned 90 minutes later.

I prepared a FAX to be sent to the neuro requesting a referral to the PD nurse et al to undertake apomorphine tests but she decided she does not wish to proceed that way without speaking to a recipient of the treatment. I emailed the PD group in Hot Air City asking  if they know of someone willing to speak about their personal experience with apomorphine but no reply yet.

She rescheduled her PD meds in an attempt to smooth out the ON times

0600 2x Sinemet 100/25, 1x Sinemet CR, 1x Deralin
0900 2x Sinemet 100/25
1000 1x Sinemet CR, 1x Deralin, 1x Sifrol
1200 2x Sinemet 100/25
1400 1x Sinemet CR, 1x Deralin, 1x Sifrol
1500 2x Sinemet 100/25
1800 2x Sinemet 100/25, 1x Sinemet CR, 1x Deralin, 1x Sifrol
2100 2x Sinemet 100/25
2200 1x Sinemet CR, 1x Deralin, 1x Sifrol

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