Chapter 517 - Times are Tougher
On Friday 26th April I cancelled the appointment she had to return to the physio at the gym at the Hub place. At the first appointment he listened to me talk for almost an hour, asked few questions, commented that her left ankle was really frozen, did not suggest any exercise although I should have asked. These people are fitness marketers or sports injury healers. I keep intending to have her complete a few exercises each day but I lack enthusiasm to force her to do much, even though I'm sure her right foot is turning inwards more and more. A couple of days ago I tried to have her stand in the fore arm walker, realising I should have persevered with having her stand after she fell backwards out of it several years ago. Now my aim is to have her use the pedal machine without powered assistance.
I am making too many mistakes with her care. Early on the Sunday morning 28th April she woke me kicking the rails on the side of her bed; she lay across it. At 0615 at the time to change the pump settings I found that I had left it running at 5.5 mL/hr overnight, instead of at 2.0. Same error was discovered at 0315 Sunday 5th May when again dyskinesia kicking of the bed rails woke me. But worse happened yesterday, Saturday 11th May, when I discovered at 0625 that I had failed to replace the cassette on the pump the previous evening. The cassette had emptied about 0400, as I calculated from the flow rates. She was a little sleepy so at 0645 I gave her a bolus dose before going through our usual routine at 0730 of transporting her to the commode then to the pedal machine. She had been pedalling when the Wild Dog carer arrived at 0750 and commented that she seemed asleep on the commode. Shaking her to wake up, she stared vacantly ahead, not responding to questions. Her mouth was full of phlegm which she normally wipes away with tissues but I needed to clear her mouth for her. I gave her some small sips of water which she swallowed readily. The carer helped me return her to bed without contemplating a shower and left at 0820. I tried to keep her awake by asking questions. At 0845 she began to cough and I wiped more phlegm from her mouth. At 0900 she accepted more sips of water and asked to get up at 0905. After some having some breakfast I showered her at 1015. The rest of the day was only abnormal from the fact that her legs exhibited no dyskinesia. Today we went shopping on Mothers' Day, all morning.
Earlier this past week I have had greater difficulty transporting her on and off the toilet and at bedtime the Wild Dog carers have certainly needed my help. Since the stiffness and lack of mobility suggested lack of medication, on the morning of Friday 10th of May I raised the daytime flow rate from 5.5 to 6.0 and during that day she was able to stand much more readily. Yesterday's problem masked any improvement but so far today she has been good and mostly without dyskinesia.
Some time ago I punched a hole in the fabric of the Duodopa pump bags so that I can write "D" or "N" (Day or Night) on the cassette labels to check whether I have replaced the cassette at appropriate times but this is only effective if I trouble to check. So now each night before turning the lights out I will write in my note book that I have checked cassette replacement as well as the flow rate.
I am making too many mistakes with her care. Early on the Sunday morning 28th April she woke me kicking the rails on the side of her bed; she lay across it. At 0615 at the time to change the pump settings I found that I had left it running at 5.5 mL/hr overnight, instead of at 2.0. Same error was discovered at 0315 Sunday 5th May when again dyskinesia kicking of the bed rails woke me. But worse happened yesterday, Saturday 11th May, when I discovered at 0625 that I had failed to replace the cassette on the pump the previous evening. The cassette had emptied about 0400, as I calculated from the flow rates. She was a little sleepy so at 0645 I gave her a bolus dose before going through our usual routine at 0730 of transporting her to the commode then to the pedal machine. She had been pedalling when the Wild Dog carer arrived at 0750 and commented that she seemed asleep on the commode. Shaking her to wake up, she stared vacantly ahead, not responding to questions. Her mouth was full of phlegm which she normally wipes away with tissues but I needed to clear her mouth for her. I gave her some small sips of water which she swallowed readily. The carer helped me return her to bed without contemplating a shower and left at 0820. I tried to keep her awake by asking questions. At 0845 she began to cough and I wiped more phlegm from her mouth. At 0900 she accepted more sips of water and asked to get up at 0905. After some having some breakfast I showered her at 1015. The rest of the day was only abnormal from the fact that her legs exhibited no dyskinesia. Today we went shopping on Mothers' Day, all morning.
Earlier this past week I have had greater difficulty transporting her on and off the toilet and at bedtime the Wild Dog carers have certainly needed my help. Since the stiffness and lack of mobility suggested lack of medication, on the morning of Friday 10th of May I raised the daytime flow rate from 5.5 to 6.0 and during that day she was able to stand much more readily. Yesterday's problem masked any improvement but so far today she has been good and mostly without dyskinesia.
Some time ago I punched a hole in the fabric of the Duodopa pump bags so that I can write "D" or "N" (Day or Night) on the cassette labels to check whether I have replaced the cassette at appropriate times but this is only effective if I trouble to check. So now each night before turning the lights out I will write in my note book that I have checked cassette replacement as well as the flow rate.
posted by Kilpike | 3:24 pm
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