Chapter 373 - Puzzling Changes
After Dr M. in Hot Air City gave his casual approval for me to reduce her Apo from 12ml to 10ml, I made the change at 2200 on Friday 19th December. The next evening I recorded that she was able to take herself to the loo, pull her slacks and incontinence pants down and up again without assistance, walked unaided to get herself a nightie, then later replaced her incontinence pants, unaided, while sitting on the side of her bed. Tasks which usually require assistance. During that day she had been at respite so there is no record during the day of her abilities.
She saw our GP Dr I. on Tuesday afternoon. A bad day, beginning with her incontinence pants leaking during the night, then I had to assist the carer from Wild Dog to get her onto the commode for a shower, then later to get her off the commode onto her bed where we both had to hold her up to dress her. At the doctor's she was a tremoring, perspiring and stressed wreck. He decided she needed to take 20mg of Lexapro, or Loxalate the generic supplied by the chemist (also known as Escitalopram), and suggested Rectinol for haemorrhoids. Dr I. had no comments about variations in her Apomine dosage. When she is incapable of applying the Rectinol herself while seated on the loo, I have her sit on the commode while I apply the cream from beneath. Wearing surgical glove of course. Also, now that she was pooping more reasonably, he said she should reduce the Macrgol to one per day.
Anyway, awake around 0100 the next morning, Wednesday, pondering the mess we are in, I decided that, although she initially responded well the day after reducing the Apo to 10ml, thereafter she was in a bad way, therefore the reduction may have been a bad move. So there and then, I got out of bed, made up a 12ml Apo/8ml saline syringe and fitted it in place of the 10ml Apo/10 ml saline syringe attached a few hours before. All during the following daylight hours she was able to take herself to and fro to the loo, push her trolley around the house, behaving almost normally. A little after 0900 I drove to the chemist and on my return she had an urgent need, taking herself to and from the loo without any difficulty. Alas, such freedom of movement was not to last, the next day her quality of life returned to what we consider "normal" this past year.
So why does she have better mobility in the 24 hours following a small step change in Apo in either direction, increase or decrease? The improvement is more than my imagination, since I made my notes without such a conclusion in mind. Only in hindsight is such an improvement noticeable, and then crudely because my notes are in noway very detailed. My temptation is to switch between 10ml Apomine one day and 12ml the next as an experiment but I am sure the Apo police may not approve.
Recently an occasional infusion site has shown a small whitish area around the penetration and later turn dark as the wound heals. And usually some inflammation beneath the op-site (used to protect the infusion area) is evident at such times. I may take her to the clinical nurse for comment.
But last night I yelled "Shit!" as I withdrew the infusion needle (only 8mm in length) because a fine stream of blood droplets squirted in an arc from her abdomen over her hip onto the bed clothes. I quickly smothered the blood at the infusion site with tissue, clotting occurred, I cleaned the area with alcohol swabs and attached a circular band aid. The site looks quite OK this morning.
She spends a lot of time using her Surface Pro 3. I am frequently call to sort out messes she causes by erratically clicking on area she shouldn't and she has difficulty remembering passwords. The surface Pro is being filled with poorly identified embroidery designs she may never use, and much paper is wasted to file details of the designs. I am about to make thing easy for her to stitch some of these designs using one of our machines at the kitchen table.
Her ability to swallow is a bother; often she swallows pills and then coughs them back up as another "gets caught" in her throat. The red coated Deralin and the large Sinemet CR frequently cause her trouble. I try to encourage her to drink a lot of water between each pill; until recently she tended to through 3 or 4 pills in her mouth at a time, a very bad habit.
She saw our GP Dr I. on Tuesday afternoon. A bad day, beginning with her incontinence pants leaking during the night, then I had to assist the carer from Wild Dog to get her onto the commode for a shower, then later to get her off the commode onto her bed where we both had to hold her up to dress her. At the doctor's she was a tremoring, perspiring and stressed wreck. He decided she needed to take 20mg of Lexapro, or Loxalate the generic supplied by the chemist (also known as Escitalopram), and suggested Rectinol for haemorrhoids. Dr I. had no comments about variations in her Apomine dosage. When she is incapable of applying the Rectinol herself while seated on the loo, I have her sit on the commode while I apply the cream from beneath. Wearing surgical glove of course. Also, now that she was pooping more reasonably, he said she should reduce the Macrgol to one per day.
Anyway, awake around 0100 the next morning, Wednesday, pondering the mess we are in, I decided that, although she initially responded well the day after reducing the Apo to 10ml, thereafter she was in a bad way, therefore the reduction may have been a bad move. So there and then, I got out of bed, made up a 12ml Apo/8ml saline syringe and fitted it in place of the 10ml Apo/10 ml saline syringe attached a few hours before. All during the following daylight hours she was able to take herself to and fro to the loo, push her trolley around the house, behaving almost normally. A little after 0900 I drove to the chemist and on my return she had an urgent need, taking herself to and from the loo without any difficulty. Alas, such freedom of movement was not to last, the next day her quality of life returned to what we consider "normal" this past year.
So why does she have better mobility in the 24 hours following a small step change in Apo in either direction, increase or decrease? The improvement is more than my imagination, since I made my notes without such a conclusion in mind. Only in hindsight is such an improvement noticeable, and then crudely because my notes are in noway very detailed. My temptation is to switch between 10ml Apomine one day and 12ml the next as an experiment but I am sure the Apo police may not approve.
Recently an occasional infusion site has shown a small whitish area around the penetration and later turn dark as the wound heals. And usually some inflammation beneath the op-site (used to protect the infusion area) is evident at such times. I may take her to the clinical nurse for comment.
But last night I yelled "Shit!" as I withdrew the infusion needle (only 8mm in length) because a fine stream of blood droplets squirted in an arc from her abdomen over her hip onto the bed clothes. I quickly smothered the blood at the infusion site with tissue, clotting occurred, I cleaned the area with alcohol swabs and attached a circular band aid. The site looks quite OK this morning.
She spends a lot of time using her Surface Pro 3. I am frequently call to sort out messes she causes by erratically clicking on area she shouldn't and she has difficulty remembering passwords. The surface Pro is being filled with poorly identified embroidery designs she may never use, and much paper is wasted to file details of the designs. I am about to make thing easy for her to stitch some of these designs using one of our machines at the kitchen table.
Her ability to swallow is a bother; often she swallows pills and then coughs them back up as another "gets caught" in her throat. The red coated Deralin and the large Sinemet CR frequently cause her trouble. I try to encourage her to drink a lot of water between each pill; until recently she tended to through 3 or 4 pills in her mouth at a time, a very bad habit.
posted by Kilpike | 11:18 am
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