Progression Two

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

Sunday, May 27, 2018

Chapter 490 - Matters Are Progressing To What End?

This may be my last post. The nerds at Google say a warning has been placed on Blogger blogs warning European readers and their bureaucratic masters of cookies and other crap Google has/maybe placed on this blog (not me, who just types personal details about growing old with Parkinsons). The nerds tell me how to check to see that message by faking things so that I appear to be a European when looking at the blog but that didn't work, so I set up a Tor browser on another machine which made me look like a peasant on the upper reaches of the Volga or of the Seine. I see this blog but it lacks said warning message. Perhaps I should download this whole blog for safe keeping.

I bought her a wooden planter box and seedlings to plant hoping such will give her an interest and overcome her need to dig in the raised garden bed with her bare hands and plant stems of flowers that have exceeded their use by dates in vases. Yes, she is interested in tending the planter box but we both get upset when she digs roots and bulbs out of the garden bed.

Ages ago she bought an unfinished quilt around which she attached a frill; the whole had been in her quilt box for ages. Some months ago she decided to cut that quilt into smaller quilts for a Wild Dog carer but then changed her mind after the woman left the job. So then attempts were made to reattach the original frill; that failed and since then 3 or 4 attempts have been made to add other frills of lace and other stuff. All failed seemingly due to insufficient frill to go around the perimeter of the squarish  (about 2 metres) quilt. Other Wild Dog carers have assisted her in partially attaching the frill, yet after they leave for the day she find something wrong and reason enough to dismantle the thing again. Same happened yesterday and since she has been attempting to make corrections by removing all the pins and stitching holding the frill in place. Unfortunately, she becomes very stressed and frustrated with her attempts leading to excessive dyskinesia.

Her knitting and crochet attempts go the same way, resulting in rats' nest tangles to be rewound into balls. Much is thrown away. I don't mind buying new balls of wool at the junk shops. She enjoyed herself at the yearly craft show down at Hot Air City, buying bags and spools of lace plus some very expensive fat quarters of fabric, the latter will be filed in a cupboard or given away; no way will she be able to even make them into patch work squares, for her ability to sew in a straight line is long gone. Her basic sewing machine is often in need of "repair" after the dialled settings are upset, needles are broken and the incorrect bobbin, Janome, is used in the Brother. When matters become awkward, she reaches for a screwdriver or, if such can't be found, the the blade of a pair of small scissors, to disassemble the sewing machine.

I have had to reduce the services Wild Dog provides for her Level 4 package for it seems services approved by local management plus contributions to a contingency fund (saving for a sling lifter) exceed the income from government plus our contribution. I am clueless about the accounting, as is the local low level management (as told me by that person) about the contingency monies. I was offered two suggested care plans but preferred one of my own, which was costed but I am yet to approve because there seemed to be trivial errors in it, so until an explanation or corrections are made I won't sign it. They wanted the new plan to commence last week but I said "No; begin on June 1st."

For the last few days she has complained of tingling in both arms and legs but no other symptoms. yet this morning her right arm tingled and was hot to the touch while the left was without tingling and heat.

When I told her that someone was to soon begin a job in a westerly suburb of Batman City she replied that the person could call in on us on her way to work. This comment puzzled me, I explained again where the job was and that calling in was not possible; she saw no problem at all, until I explained that we last lived there 17 years ago, and then the penny dropped.

We met with the Ugly Sisters for lunch in the High Lands last Friday when she won a $20 voucher at a local store. We visited the store on our way home; she chose a cushion with tassells.

Her Duodopa flow rates continue to be adjusted as instructed; Daily rate 5.7, Night Rate 2.2 and Morning Dose 5.5 beginning Saturday 21 April until Thursday 24 April when the rates changed to Daily rate 6.0, Night Rate 2.2 and Morning Dose 4.5. I see no real improvement or worsening, just "some days are diamond, some days are stone". I will post more FitBit traces from her right leg on my next post.

Her fluid intake remains abysmal;  on a some days she may drink a 450mL bottle after getting up, most days only part of that. She complains of drinking fruit juice containing Benefibre. At times her bowel motions are reasonable, perhaps fewer log stays sitting on the loo, dropping the odd pebble or two. A couple of times she has filled her pants while getting to the loo which is quite unusual.

Friday, May 11, 2018

Chapter 489 - Minor Changes

Living 24/7 in a situation hides ones appreciation of gradual changes. One morning a week or so ago while I was positioning her commode chair at her pedal machine I wondered why she was not exclaiming that I was hurting her feet and toes. For I can't remember how long her feet have been so sensitive to touch that she needs to wear shoes whenever not in bed. The shoes are just cheap slip-ons bought at Kmart and have served her well except for a few, still in new condition, on which she removed the elastic straps, intending to modify such for greater comfort. Anyway, on that morning I realised that she no longer insisted on replacing her shoes when removed from the slippers glued onto the pedals of the machine (a pair of large men's slippers glued to the pedals to prevent her feet slipping of those pedals) and I had no idea how long she had not asked the Wild Dog Carers to not bother with her shoes when the wheeled her on the commode from the lounge room into the shower. Next day I queried her about this and she replied "I don't need to do that anymore". In general, her feet don't seem to bother her as they once did. The most I recall her saying of late is that her feet are heavy.Usually late of an afternoon she needs raise her feet onto a chair. The leg/feet supports on her new wheel chair seem of little use to her.

On some days her leg dyskinesias are minimal, on others very bad, onset usually occuring early afternoon. A surprise last Tuesday 8th May, when her dyskinesias were minimal until a short but strong burst at 1800. But first, some background. At her last visit to her neurologist Dr F. I was asked to modify her Duodopa pump flow rates to the following :-

Month 1: 24 March - 23 April Daily Rate 5.7 Morning Dose 5.5 Overnight Rate 2.2
Month 2: 24 April- 23 May Daily Rate 5.9 Morning Dose 5.0 Overnight Rate 2.2
Month 3: 24 May - 23 June Daily Rate 4.5 Morning Dose 6.0 Overnight Rate 2.2

Then from Tuesday 10th April she attended a "Dance for Parkinson's Disease" class at the Church Hall at St Nick's for 4 consecutive Tuesdays. She enjoyed the activity and social contact. There had been several trial classes late last year. Such classes have been conducted in several countries in recent years. At home I showed her the streamed lessons from capture.nbs-enb.ca/dwp/Home.aspx, some of which she followed, seated in her wheel chair. The local classes have now ceased for want of funding. While she attended the classes at St Nick's I had cancelled the Tuesday "Physio" sessions given by a visiting Wild Dog Carer on Mondays, Tuesdays and Fridays. So this week I asked that the Wild Dog Carer participates with her to follow along with the streamed class "Dance Classes for People with Parkinson's, Toronto. ON for March 20 2018".

As mentioned in earlier posts, for a long time now I have monitored the dyskinesias of her right leg with a FitBit device. At our last visit to Dr F. he said it was obvious from the printed FitBit charts I had sent him that the earlier duodopa flow rate adjustments had been ineffective; and that was why we are now using the programme shown above.

Not expecting to notice any change in the FitBit charts, I was quite surprised at the one for last Tuesday. There had been no obvious changes in the FitBit charts on the days she had attended live classes at St Nick's.

Below are the charts for 7th , 8th and 9th May, each annotated with flow rates and FitBit on and off times of attachment around her right leg.






The Wild Dog Carer will be here in about 30 minutes when I intend to have the two of them "dance" along with the same streamed class and the FitBit results will be reported in my next post, whenever.