Saturday, August 23, 2008

A Rough Start: What Next? Maybe I Shouldn't Tempt The Fates By Asking!


“GOD DAMN IT! Don’t ask me again! That’s the FIFTH time you’ve asked me and I don’t want to talk about it anymore!”

I hear my father shouting at my mother as I walk carefully down the worn steps leading away from my upstairs bedroom.

“Oh no! It’s only 7:51 a.m. and she’s up?” I think.

The first five weeks after I moved home to care for my parents, I had to wake my mother from a sound sleep every morning at 9:00 a.m. The time change occurred last Saturday and I thought she would transition well to it, sleeping an extra hour each morning. But this past week, she has woke up earlier and earlier each day. I can’t seem to get up before her, even when I set my clock.

“I just want to know why I can’t have ANY COFFEE!” my mother snaps back at my father. She is diabetic and has not had her fasting blood sugar test yet. My father is denying her coffee until I get up and test her.

I step on the carpeted floor of the hallway, walk quickly down its two bedroom length and turn the corner into the living room.

My mother is leaning forward on her green velour lounge rocker, with a frustrated look on her face. She was diagnosed with Alzheimer’s three years ago and cannot form new memories easily. Lately, she seems to fixate on one question or comment and repeat it throughout the day.

She is dressed in the black pull-on pants and printed blouse that I laid out in the bathroom last night. I discovered that if I leave a pair of protective underwear on the shower seat, in front of the toilet, she will put them on if she wakes in the middle of the night and finds herself wet. I applied that idea to her clothing and started putting the next day’s clothes in the bathroom closet at night. She has found them on the mornings she gets up early and has dressed herself.

My father is leaned back on the new, tan couch. He is visibly upset and angry. Earlier this year, after his second bout of chemo for lung cancer was finished, he began to hallucinate. The doctors did tests and told my father that the cancer had spread to his brain stem. The hallucinations have been brought under control with Thorazine, even as the inoperable cancer grows. Last Friday, he began to hallucinate again. I have added another Thorazine to his bedtime dose and the increased dosage has made the little girls in white, who poke needles in his eyes, disappear.

I stand in between the green rocker and the tan couch. “DAD, YOU CAN WAKE ME UP WHEN SHE GETS UP.” I shout. My father is hearing impaired.

“Ahhhh!” He growls and waves his hand at me, as if to wave me away. The irritation he feels is mirrored in his expression. He reaches for the remote and mutes the booming surround sound system, fed by the TV. “Whaaat?” he drawls.

“IT’S OKAY IF YOU OPEN THE UPSTAIRS DOOR AND CALL ME WHEN SHE WAKES UP. I WAKE UP REALLY EASY. I’LL GET UP AND HELP.” I tell him.

“You’re up late writing your book. You need your sleep,” he says. “Besides, you always wake up before 8:00.”

“DAAAD! WHEN I WORKED IN SAN DIEGO, I GOT 3 HOURS OF SLEEP A NIGHT, MOST NIGHTS, AND I FUNCTIONED FINE. I’LL BE OKAY AND IF I’M NOT, I’LL TAKE A NAP WHEN MOM TAKES HERS.”

He shrugs his shoulders. I’ll set my clock earlier for tomorrow, because I know he won’t wake me up.

I turn to my mother. “Mom, Let’s get you up to the table and I’ll take your blood sugar. Then you can have your coffee.”

My mother scoots to the edge of her green rocker. She leans forward and pushes herself up from the worn arms of the chair. She balances her weight, hands gripping the chair arms and gets her feet underneath her. She grabs her cane, holds out her free arm for me to hold and walks, supported to the table. She sits in a table chair and waits for me to set up her testing kit and insulin.

I sit next to her. I give her an alcohol swab to clean a finger. After she wipes her finger with the swab, I hand her the Ulti-Lance® Automatic Adjustable Lancing Device to prick it. She positions it on her finger, pushes the trigger and says, “Ouch!”

I load an Eclipse test strip into her GlucoLab™ meter and as she squeezes blood from her finger, I apply the test strip. The capillary action of the test strip pulls the blood from her fingertip.

“Five, four, three, two, ONE!” I count down with the meter. “Oh no! Your blood sugar is 229!”

“Is that good?” my mother asks. Four years ago, she tested daily and maintained a diet that kept her blood sugar between 90 and 130. That’s the goal we are now trying to make.

“It’s too high, Mom.” I tell her. I show my father.

“229?” he asks. “What’s she been doing?”

“I THINK I SHOULD HAVE GIVEN HER A HALF OF AN ORANGE LAST NIGHT, INSTEAD OF A WHOLE ONE.” I say.

“Okay.” He walks back to the couch, shaking his head. Last week she tested 130 and 131 on two consecutive days.

I insert the BD Ultra-Fine® II insulin syringe into the Lantus®, turn the bottle upside down and withdraw 10 units of insulin.

“Where do you want it?” I ask.

She slides up her left sleeve. I wipe her upper arm with another alcohol swab. I insert the syringe. It resists, then goes in. I wince and quickly plunge the insulin into her arm. I pull out the syringe and rub the injection site with the alcohol swab.

“How’s that? I ask.

“Pretty good,” answers my mother. Apparently she didn’t feel the resistance.

“I’m setting up a new needle for tomorrow.” I tell her. I toss the old needle into the sharps container on the end table we use for the medicines.

“Now, I’ll get you coffee.” I tell her.

“Finally!” she says.

I notice her feet are bare when I set her black coffee on the table in front of her. I walk to her bedroom, get a pair of socks and hand them to my father. He has developed a ritual of putting her socks on her each morning. She insists she can’t bend down to put them on, but every once in a while I see her do it. Not today, though.

“Oh! Your feet are bare,” says my father. He hobbles to the table, bends down and puts her socks on. “I get to gaze upon your lovely, painted toes.”

“You’re a keeper!” she says and gives him a smile. This is why he puts her socks on each morning. He likes to hear that specific compliment.

I go into the bathroom to change into clothes. I see her used protective underwear lying on the floor under the shower seat at the same time I step into a wet spot on the carpet in front of the sink. I sigh and pick up the underwear. It has soaked through the carpet in front of the toilet and left droplets of urine on the floor tile. I throw the underwear into the waste basket, pull the liner out and tie it closed. I pull the extra liner from the bottom of the trash can, shake it and line the can with it. I pick up the rugs and pile them outside the bathroom door, along with my mother’s nightgown. I take a Clorox wipe and clean the floor. I reach into the closet for clean carpets and place them on the cold tile in front of the toilet and sink. I wash my hands, change from my nightgown and pick up the trash bag and dirty clothes, as I leave the bathroom. I drop the clothes into the laundry basket on the back porch and throw the trash into the trash can on the patio outside. I wash my hands, again, take the clothes out of the dryer, transfer last nights wash into the dryer and then fill up washing machine with a new load. I start the machines. I wash my hands a third time.

I throw defrosted ribs into my computerized Crockpot for tonight’s dinner. I cook a breakfast of ham, eggs and toast. I serve my mother at the table and my father on the couch. I set my place next to my mother. We eat silently, while the TV blares and when we’re done, I collect the dishes to soak in the sink.

My mother gets up, walks to her green rocker and sits down. “Will you bring me coffee?” she asks me. I rewarm her coffee and bring it to her.

There is a knock on the door. Our Maltese, Roxie, growls and begins to yip shrilly. I answer the door, while shushing the dog.

“I’m from Pacific Power. I’m here to collect on an overdue bill,” a woman says.

“I paid them!” my father hands her a bill for September marked paid. It’s now November.

“Sir, you’ll have to look in your checkbook,” she says, looking a little unsettled.

I follow her gaze and notice he has blood under his nose. It looks like the toothbrush moustache that Hitler wore. I make a mental note to tell him after the Pacific Power lady leaves. He steps back into the house.

“He has brain stem cancer.” I tell the lady, to explain the September bill. “How much is the bill? Do you take credit cards?”

“Oh. I’m sorry,” she answers. “$180.88 is due. You’d have to call it in over the phone if you use your card. I can take a check.”

“Even if it’s a California check?” I ask. Some companies don’t want to take out-of-state checks.

“Don’t matter to me,” she says.

I write out a check. I ask if the company will credit the double pay to his account when they get the check he sent. She assures me they will.

When I go back inside, I see that my father has laid out all the bills on the table. He is searching for the power bill.

“IT’S TAKEN CARE OF, DAD,” I tell him.

“There!” he says, pointing at an entry in his checkbook. Instead of writing Pacific Power, he had written the monetary amount on the payee line, when he recorded the transaction in his checkbook.

“OKAY.” I said. “NEXT MONTH IS ALREADY PAID FOR.”

He starts trying to figure out what bills he has paid and what bills he owes. The piles of bills are too overwhelming and he says, “I’ll do this later. The checkbook’s a mess.”

“YOU CAN TAKE IT TO YOUR BANK AND THEY WILL BALANCE IT FOR YOU.” I tell him.

“Ahhhh.” He shakes his head, “I don’t want them to see how I messed it up.”

“YOU KNOW, THEY’VE PROBABLY SEEN WORSE.”

He shrugs, gathers the bills into piles and shuffles off to the couch.

“I don’t know what’s wrong with me. I think I’ll go to bed,” says my mother.

“No, Mom. You just ate. You’re blood sugar is up. Drink some water. It’ll make you feel better. You have to wait until after lunch to take a nap.”

She looks at me as if trying to figure out an argument to rebuke my statements, and then she takes a drink of water from the bottle on the end table. “I can’t take a nap?” she asks.

“No. If you sleep now, you’ll stay in bed all day, and then be up all night. It’s not fair to the rest of us.” I tell her.

“You can stay up to entertain me.” She grins, widely. Her eyes are devoid of cunning. They look as innocent as a two-year old’s eyes.

I smile and shake my head. She continues to grin at her joke. I know the focus of the questions of the day. They’ll be about napping.

I hit the ground running this morning, when I wanted a slow start. It’s calm now, but I can’t help but think, “What’s next?”

Maybe I shouldn’t tempt the fates by asking.

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