Wednesday, July 30, 2008

Dreamer: I Wonder What She Dreams About


I sit looking at my mother as she sleeps sitting up in her chair. The crooked fingers of her arthritic hand flutter against the top of her cane. Her mouth puckers and she sucks at something in her dreams. I wonder what she dreams about.

Earlier she tried to give my father her chair. He’s only sat in it twice since they got it years ago. He was watching TV, caught up in the plot of a war movie. She turned and looked at him.

“Do you want your chair?” she asked.

He saw her mouth moving and turned to look at her. “What?” he asked. He has been slowly going deaf for years. He doesn’t wear his hearing aid because it feels funny in his ear and whoever talks to him has to yell to be heard.

“Do you want your chair?” she asked again, this time a little louder.

“I don’t know what has gotten into you these past few days.” he said, “You’ve been trying to give me your chair.”

“Well, I must be going nuts. I don’t know,” she answered.

Her fingers grip her cane, and then relax. She holds it loosely against her plump belly. Her foot taps the carpet once, and then rests. She sighs and her chest rises and falls slowly with her breaths.

“Does my sister have dementia?” She asked me this morning.

“Yes, she does.” I answered.

“Did she go to live with her daughter?”

“Yes.”

“Why?” she asked.

I sigh and then tell her. “She needs a caretaker.” It never fails to surprise me that my mother doesn’t recognize her own dementia or that I am her caretaker. Maybe it’s a blessing.

“She was always the self sufficient one. I’ll miss her.” She said, shaking her head sadly.

As I watch her sleeping, she startles and then opens her eyes. “Do we have any ice cream?” she asks.

“Yes, we do. Do you want some?” I ask.

“Yes!” She licks her lips.

“I’ll get some for you,” I tell her. I smile. I know what she was dreaming about.

Tuesday, July 29, 2008

My Dad Has A Brain Tumor And It's Inoperable


I drove my father to his doctor’s new office, yesterday, for a general checkup. We talked about the wooden beams bracing the ceiling and the glass block walls in front of the reception area as we waited. Everything seemed to be alright. After a lengthy wait in the lobby, the nurse called him in, weighed him, and showed him to an examination room where she asked him to get up on the exam table.

“DAD, DO YOU WANT TO SIT IN THIS CHAIR? MOM SAT IN A CHAIR WHEN SHE WAS HERE.” I said loudly. My father can’t hear out of his left ear and has impaired hearing in his right ear.

“Nah. She said ‘the table,’” he answered.

Once my 78 year old father shakily perched himself on the table, the nurse told him that he needed to have his Coumadin levels checked. She pricked his finger, put the blood on a test strip and waited for the results.

I asked, “What’s a Coumadin?”

She looked at me and said, “It’s his blood thinner medicine. We have to check his blood every month.” She looked sideways at my father and winked. “JOE HAS NOT BEEN TOO GOOD ABOUT THAT,” she said loud enough for him to hear. He smiled.

I said, “We’ll have to change that.”

She continued, “If his blood gets too thin, he could hemorrhage. If it’s too thick, he could have a stroke. Aaaand…,” as the test unit beeped, she looked at the test strip, “It looks good. Keep his dosage the same.”

“Okay.” I replied.

She wrote the information into his chart, and then looked up at my father, waiting on the edge of the exam table, “DOCTOR WILL BE IN TO SEE YOU IN A LITTLE BIT.”

While we waited, my father strained to look out the window. The window shade was the type that closed from the bottom to the top. It covered the lower half of the window, blocking the view of everything, but the grey, overcast sky. I walked over and adjusted it, so he could see the trees covered in yellow, orange and red foliage and the birds practicing their flight south.

The doctor came in, said hello and checked my father’s chart.

“HOW ARE YOU DOING?” he asked my father. He nodded to me.

“Oh, okay,” my father answered.

“WELL, TODAY WE’RE GOING TO TAKE BLOOD FOR YOUR CEA.”

“What’s a CEA?” I asked the doctor.

“It stands for cancer embryonic antigen. It’ll tell us where the colon cancer has gone.”

I took notes as he spoke.

He turned back to my father. “ARE YOU GETTING A FLU SHOT?”

“Yes! I almost forgot about that,” answered my father.

The doctor checked the chart once more. “THEN I’LL GIVE YOU THE PNEUMONIA VACCINE, TOO. IT’S DUE.”

My father nodded.

The doctor stood up. “THE NURSE WILL BE IN TO POKE YOU,” he nodded to my father, then to me. He handed me a lab sheet that had itemized procedures listed on it. He had circled the items for my father’s treatment plan.

My father adjusted his seating and grimaced. “I gotta… get off …this table. My legs…they’ll lock up,” he said.

He slid forward and eased off the table. He walked to the window and looked out at the new construction going up just west of the doctor’s office. He walked around the small room and looked at the autographed and numbered duck prints mounted on the walls. The expression on his face said he wanted to be anywhere but in that room.

The nurse opened the door and entered the examination room. She took the lab sheet and read the doctor’s orders.

“I’M GONNA POKE YOU A LOT TODAY.” She said to my father. She set up for a blood draw.

I said, “YOUR BIG VEINS MUST MAKE IT EASY TO GIVE BLOOD.”

My father answered, “That’s what they say. Then they go to take blood and find out they roll. They think I have good weins….Damn!”

“VEINS?” I prompted.

He nodded and didn’t talk very much after that. After his blood draw, two vaccinations, and the nurse’s promise to call with the results of the CEA test next week, he was in a hurry to leave. I had to stop him from walking out of the office while I made his next appointment.

On the way home, I said, “LOOK AT THE COLORS OF THE TREES. THOSE RED LEAVES ARE SO BEAUTIFUL. IT’S WONDERFUL TO SEE THE SEASONS. WE DON’T GET THAT IN SAN DIEGO. IT’S ONE SEASON ALL YEAR ROUND.”

“It’s as good as….it’s as good as…,” my father stammered, then stopped.

I turned slowly to look at him, as I drove. He looked scared. He raised his hands, palms up, in front of him as if to say, “I don’t know what’s wrong.”

I asked, “ARE YOU HAVING TROUBLE TALKING?”

He nodded, then looked down towards his lap. He slouched in resignation. His ruddy complexion paled. His eyes watered, yet his jaw tightened in defiance. He still had fight in him.

“IT’LL COME BACK.” This had happened once before.

He looked really scared. This man, who fought his last bar fight in his 60’s, who outran cops rather than be apprehended, and who ruled his kids and his wife with an iron hand, was helpless against the tumor growing on the left side of his brainstem...the side that controlled language. I took him home and fed him. He ate silently and then took a nap.

After his nap, he began to speak, again, although slowly. “I couldn’t talk. I couldn’t understand what people were saying. I still can’t see right. It’s like being cross eyed.”

Later that night, he told me he had a horrible headache. I knew the tumor had been growing, putting pressure on his brainstem, causing the speech dysfunction and the pain.

“DO YOU WANT A VICODIN?” I asked.

“What’s that?” I give him Vicodin twice a day for pain management. Hospice has prescribed them for the pain his cancer causes. The prescription says I can give him up to three pills, twice a day.

“IT’S FOR PAIN.”

“Yeah, I’ll have one of those,” he said.

I gave him one and he went to bed. Later, I woke him for his last set of medications and asked him how his headache was.

“I must have slept it off,” he answered. He took his medicine and quickly went back to sleep.

My father has said that he felt he would die on his 79th birthday. It’s in two days. I’m hoping that when he goes it’s with clarity of mind, so he can hear me tell him to save me a place on the other side.

Sunday, July 27, 2008

You Can Never Go Home: The Poopsident Experience


“Ruuuurt!” I hear my mother belch, after she pushes her empty plate away.

“Oh Mom,” I say, “I forgot to give you your burp pill.” I hurry over to the medicine drawers sitting on the bookcase next to the table.

“Why are you giving me a burp pill?” she asks.

“You just belched a really stinky burp. These pills keep your burps from smelling so bad,”

“You think I burped?” she says. “I farted.”

“Well that makes me feel better. I thought your burp smelled like a fart.”

She starts to get up from the table. “Come on. Come on. Come on.” She says as she leans forward and pushes on her cane to boost herself up.

“What are you doing, Mom?” I ask her.

“I’m going to the bathroom.” she replies. “Oh no! I’m shitting myself.”

“You are?” I ask.

“I don’t know what’s wrong with me. Damn!” she curses.

I follow her into the bathroom. She pulls down her pants and sits on the toilet.

“Shit! Shit! Shit!” she says as she looks into her pants.

“It’s okay, Mom.” I say. “Let me help.”

She starts to take off her pants by planting her cane in the crotch of her underwear to pin them to the floor, while she pulls her legs out of them.

“Wait Mom!” I tell her. I lean down and pull her pants and underwear off. I throw the pants in the hamper and the underwear in the garbage.

“Are we rich?” she asks.

“Sure we are, Mom.” I answer while pulling off her socks. “Let’s get you into the shower and wash off your butt.”

“Shit. I don’t know what is wrong with me.” she says.

“Shit happens, Mom.” I answer, setting up the shower seat in the bathtub and adjusting the water temperature.

“I must be getting old. Just shoot me!”

“Not my Mom!” I tell her. “Let’s transfer into the shower.”

She leans forward, pushing up on her cane and on the corner of the shower seat. “Shit! Shit! Shit! Shit! Shit!”

I spray the toilet seat with disinfectant soap, after she clears it, and quickly wipe it down with a wet wipe and flush it, before she turns around. She plants her bottom on the shower seat and lifts her left leg over the side of the tub.

“Scoot over, Mom.” I tell her.

She scoots her bottom to the left and reaches for hand placement before swinging her right leg over the tub side. She retracts her hand as she sees the diarrhea smeared across the shower seat.

“What happened? Did I shit myself?” she asks.

“Just a little.” I say to her. “I’ll clean it up. Just get in the tub and we’ll get it done. Here’s your cane to help you.”

She uses her cane to lean on as she swings her right leg into the tub.

“Stand up, Mom and I’ll wash your butt.” I say to her. She slides to the edge of the shower seat and leans forward to grab the hand held shower head lying on the tub bottom.

I squirt liquid soap onto a scrubby and rub tight circles on the soiled shower seat as she rises. “Hand me the shower head, Mom.” I tell her. She does and I rinse the shower seat and the scrubby.

“Can I sit?” she asks.

“Wait a sec, Mom.” I say. “I’m going to wash your butt, first.”

She stands in the shower, bent at the waist, waiting. I turn the shower head to a solid stream and pull my mother’s butt crack open. I hose her anus, and then wash it with a scrubby. I rinse her. “Okay, Mom, you can sit down now.”

She backs up to the shower seat and lowers her butt, then leans back to a sitting position. I hand her the soapy scrubby. “You wash your ‘who-see-whats-it!’” I tell her.

She cleans herself and rinses off, spraying herself, me and the floor. I pull the shower curtain to catch most of the spray. I laugh at the expanding wet spots on the thighs of my denim capris.

“Hey, Mom, hand me the shower head and I’ll wash your back.” I take it from her, lather and then rinse her back.

“Can I turn it off yet?” she asks.

“Yes.”

She leans forward, still seated and turns off the water. The shower head lies in its resting position on the bottom of the tub.

I hand her a towel. She dries her front side, and then scoots toward the edge of the shower seat. “It feels slippery.” She says.

“It is.” I acknowledge.

She lifts her right leg and clears the tub side. She tries to lift her left leg.

“Wait, Mom.” I say, “You have to scoot over a little more before you lift your other leg over the side.”

She slides to the edge, and then tries once more to lift her left leg over the tub side. She balances precariously for a moment, then leans forward to grab the toilet seat for support.

“Here, Mom.” I say, “Use your cane instead of the toilet seat. The toilet seat is a nasty thing to grab hold of.”

“Oh.” she says as she grabs her cane and uses it to hold her weight as she transfers to the toilet seat.

“Mom,” I say, “Stand up and let me dry your butt.”

She stands again and I dry her back, butt and the toilet seat. “Okay, Mom, you can sit now. Stay right there while I go get you some pants.”

I move quickly to her room, find a pair of pants that matches her blouse and return to the bathroom. I give her a front clasping bra. She holds it in front, slides her arms under the straps, lifts it over her head and clasps the correctly placed bra. I marvel at how she masters the complexity of putting on that bra. I hand her the blouse she had on prior to the poopsident. It is buttoned up the front. She opens the bottom, puts her arms into the sleeves and pulls it over her head.

I pull open a pair of disposable, protective underwear and hand it to her. She puts them on the floor, steps on the left side of them, stabs her cane into the right leg hole and uses it to pull the underwear outward to make an opening for her foot. She pushes outward and pulls upward to guide the underwear up to her ankle. She uses the cane to pull the underwear onto the left side. I wonder how she came up with the idea of how to do that. I hand her a clean pair of pants and she uses her cane to put them on, the same way as the underwear. When they are pulled up to her calves, she leans forward to pull off five squares of toilet paper, and wipes herself from the back. Afterward, she holds on to the edge of the sink and the side of the shower seat and pushes herself up. Standing, she reaches down and pulls up her underwear and pants.

She moves to the sink and sees herself in the mirror. “I’m an old woman!” she says. She picks up a comb, wets it under the water faucet, and drags it through her hair. “I look like Don King! If I had his money…”

I laugh. “Mom, wash your hands.” I say.

She touches the soap, rinses her hands and reaches towards the towel. “Mom, use the soap. Put it in your hands and roll it.” I tell her.

“You’re going to make me do that?” she asks.

“You taught me to wash after going to the bathroom.” I answer.

“Good girl.” she says. She picks up the soap and rolls it between her hands, working up a little bit of lather. She rinses again and dries her hands on the bottom of the towel. She leans towards the toilet and flushes it, then grabs her cane and turns to leave the bathroom.

“Do we have something crunchy to snack on?” she asks as she heads out of the bathroom.

“You just ate Mom.” I answer, knowing that I will be answering questions about food for the rest of the day. Such is the care for an Alzheimer’s victim.

Saturday, July 26, 2008

The Hospice Card: What Will I tell Her When He's Gone?


“What’s that green card?” my mother asks. She is diabetic and has Alzheimer’s.

“What?” asks my father. He is deaf in one ear and has impaired hearing in the other.

“The green card…” she says softly at first and then, “THE GREEN CARD!”

“What green card?” my father asks.

“It says Mercy Hospice,” she prompts.

The card in question is taped to a list of emergency numbers and attached to the wall next to the calendar. It tells the hours of operation of Mercy Hospice for weekdays from 5:30 a.m. to 7:30 p.m. and after hours, weekends and holidays. It gives phone numbers for each time frame and says to ask for the nurse on call. The card is for my dad. He has a cancerous tumor on his brain stem. The doctor’s gave him 5 ½ months to live 6 ½ months ago.

“Hot spice?” he says, teasing my mother with his favorite vernacular for Hospice. He likes word games.

“Hospice. HOSPICE!” My mother says the words slowly and loudly. “What is it for?”

My father gets up from the couch, and shakily walks across the living room to the calendar wall. He nearsightedly fumbles with the various papers and cards taped to the wall around the calendar.

“Green. GREEN!” barks my mother. “Why is it there?”

“Hot spice.” My father says as he finds the neon green card.

In a split second, he makes a decision to spare his forgetful wife of 55 years the truth of the matter. It brings tears to my eyes as I stand in the kitchen, cooking breakfast for them.

“I don’t know.” he says, “You expect me to know everything?”

“Well, that’s why I MARRIED YOU. Now, you DISAPPOINT ME.” She says teasingly, punctuating the last two words of every sentence by yelling them, a recent symptom of her Alzheimer’s.

I swallow the lump in my throat. Even though she is teasing like she always has, the message is hurtful when put in perspective. He doesn’t tell her so he can save her from hurt. She says the thing that hurts, because she is unaware of his dire situation.

And I wonder what I will tell her when he is gone.