Tuesday, March 16, 2010

Things are a Little Better

As the title says things have been a little better since last time I blogged.

Thursday evening wasn't too great however. I had cooked one of Margaret,s favourite meals, Shepherd's Pie, but soon after we had sat down Margaret became upset over something, but I didn't know what. She then got on to my being a liar about Louis and the wine incident and finally ended up screaming at me and taking herself of to her bedroom with out touching her dinner. After a while and when I had finished my dinner I went and asked her if she wanted her dinner warmed up and she said that she didn't want it. I saved some for Louis' dinner on Saturday, threw the rest away and cleared up before settling in front of the TV. About 8.30 pm Margaret came into the lounge and said that she was hungry and wanted another glass of wine ( No.2 and we are both counting now). She wanted a peanut butter sandwich so I made her one and she settled down as if there had been nothing wrong. Louis even came out from his hiding place and joined us. Finally I worked out that she had been upset by a phone call from Blue Care which I had received earlier in the day asking me to confirm that I wanted respite care this coming Wednesday while I went to my computer club. Margaret said that she didn't want respite care and I could leave her on her own for four hours. I told her that I could not do that and she was off again and went to bed at about 9.30 pm. I went in later and settled her down for the night making sure that she took her medications.

Friday morning she woke up in a reasonable mood and we decided to go out to a local Thai restaurant for lunch. It was a great success. We both had a mild curry and rice which was superbly cooked by the owner. She is a little Thai lady and her children, a boy and a girl both about 20, serve at the table. One thing about living in a tourist area is that there are plenty of good little restaurants.

After lunch Margaret had a rest and got up about 6.30 pm for a sandwich and her glass of wine (No. 1). She watch TV with me and a bit later asked if she could have another drink and I said she could (No.2). After that program we were watching ended she went to bed. It had been a good day.

Saturday she was very tired, a side effect of toxin build up is lethargy, so she remained in bed while I did the washing. We have had several weeks of heavy rain but Saturday was bright and windy so everything dried beautifully and there was no washing drying around the house and garage. Dinner was cold roast chicken and salad which Margaret likes and we had a bottle of sparking white wine which we are not allowed to call champagne in Australia but it tastes much the same:) Margaret doesn't like The Bill which I watch on Saturday evening so she went to bed early after her second glass of wine. Another good day.

Sunday it rained and I caught up with the inside housework while Margaret rested. Not much happened and apart for a little spat from Margaret when I couldn't understand what she was trying to say - something about "what's his name's whats it"- she was in a good mood. In the afternoon I backed up Margaret's computer as she has developed a habit of deleting her photos after she views them. I will be able to do a complete restore every couple of days. She spends a lot of time just browsing her photos so it is very important that she doesn't loose any. Luckily I have stored most, if not all, of them on a Network Attached File Server, and on CDs so I can generally get them back for her. Note that somehow or other she also empties her rubbish bin each time she logs off so it is not just a simple restore job. We had a light evening meal and Margaret went to bed early after 2 1/2 glasses of sparkling wine.

Monday was much of the same. Margaret being very lethargic and docile ( I love that word!). I cooked marinated chicken pieces in our Weber kettle for dinner with roast potatoes, vegetables and gravy. She said, "I don't like it and the is too much". She then proceeded to eat the lot. We had a couple of glasses of wine each and she went to bed at 9.30pm.

Today she is still in a good mood. She doesn't want out come out to the library with me and will rest up.

Her GP, A, thinks that Margaret's condition is stable at present so we have month off from blood tests etc. However because of her limited (25%) renal function toxins are still affecting her brain and causing this lethargy. It is probably that she will remain in this state until her renal function drops again which could be triggered by an infection, flu or some thing like that. While she is quiet I can cope and I hope that last weeks behaviour doesn't return. The test will be tomorrow when the the Blue Care respite carer turns up and I disappear for the afternoon.

Thursday, March 11, 2010

A Really Bad few Days

Ola commented that I hadn't blogged for a few days and asked how we were. The answer is not too good.

I wont dwell on day to day activities which when things are going well don't change too much but just explain why I have been quiet.

I first started caring for Margaret in 2004 following several episodes of congestive heart failure caused by hypertension and Renal Artery Stenosis following many years of Crohn's Disease and arthritis. Margaret was still driving at the time and going out to do light shopping once a week but I took over most of the household duties.

In 2005 Margaret had what was described as "a complete rheumatological failure" with swelling of most of her joints and vasculitis. During this period she suffered the first of several mini strokes which affected her left side of her body slightly and even more importantly caused mild vascular dementia. She became less able to cope with day to day activities and I applied for official care status from the Australian Government for which I receive a payment of $104 every two weeks!

In 2006 Margaret had an undefined but widespread infection which hospitalized her for several weeks before it was discovered that she had diverticulitis. Surgery was performed to carry out a partial bowel resection where the Sigmoid Colon was removed which with her Crohn' Disease meant that Margaret would have continual bowel incontinence problems from then on.

In 2007 and 2008 Margaret had a series of falls causing multiple bruising and even fracturing her eye orbit. She had multiple problems and spent some time in Intensive Care having blood transfusions to restore her hemoglobin levels. At this time she was assessed by the Government as requiring Constant Low Level Care which gave her access to more support which is when Blue Care became involved.

In 2009 she was hospitalized five times and spent over two weeks in intensive care. In August she had a fall and apparent heart failure. In fact she had had two recent mini strokes affecting her balance and more seriously was suffering acute renal failure. This was stabilized and she spent two weeks in rehabilitation to get her back on her feet. Before releasing Margaret I was counseled by the hospital's sTaff on Margaret's future. She could have been transfered to a Nursing Home for frail aged persons or I could continue to care for her at home. By this time her driving license was revoked and we sold her little car. In October I started this blog

I had the romantic idea that caring for Margaret would be a self rewarding task but in fact it has become a daily grind without many rewards. Margaret's dementia has increased dramatically and she has become more and more selfish. If anything upsets her she get really annoyed and abusive towards me. I am told that this is the effect of the toxins in her blood affecting her brain.

Some things are just a little irritating and occasionally amusing. An annoying thing is her inability to understand times or dates. On the day of her Doctor's visit this Tuesday she asked me when she should get up and I said about 9.30 am. This was at 7.00 am and I don't exaggerate when I say that she wheeled herself out to ask me the same question 5 more times but at 9.30 was fast asleep and didn't want to get up.

An amusing incident was on Wednesday when following a minor accident Margaret had put her incontinence pants in a kitchen tidy bag with handles. She she couldn't find a clean pair. By the time I got to her following her calls for help she was standing with her feet through the handles of the bag with the soiled pants still in it complaining that she didn't know how to get them on. I calmed her down but couldn't help laughing at the ridiculous sight.

The thing that has got me really upset is Margaret's reaction to a minor event which occurred on Monday night. She had made a fuss about having more that her normal ration of wine and refilled her glass. I gave up and went into the kitchen to empty the dishwasher before going to bed. I could her her calling Louis and offering him wine to drink. This annoyed me and I told her to stop. Since then she has started calling me a liar and that she was feeding Louis, At the time she told me that he wouldn't drink the wine anyway.

Things were tense during her Doctor's visit. Actually her blood tests showed that her kidneys were holding on at an eGFR of 28. Poor but better tan we had hoped for. While not knowing the story behind the tenseness A, the Doctor, told Margaret how proud he was of her to keep going on and what a good job I was doing looking after her. Margaret was noncommittal in her response an I bit my tongue.

Wednesday morning I received a call from Blue Care asking if I still wanted my respite period next Wednesday to go to my Computer Club. I confirmed the arrangement but Margaret overheard me. She made a fuss most of the day saying that she didn't want anybody in the house checking up on her and that she was going out on her own. This is funny as the previous day A had said that she must always use her wheelchair when she goes outside and she really can't wheel herself. I ignored the fuss and didn't respond.

Things were still tense over dinner and afterwards we had the same act over wine. She got very abusive and brought up Louis and wine again. She told me I was a horrible person and a liar because she had not had as much to drink as I said and that she had never given wine to Louis. The later became the important thing and she screamed and verbally abused me until she went to bed. She continued, from about 9.30 pm to 1.30 am, getting out of bed and coming to abuse me. She would ram her wheely walker against my bed to wake me, scream abuse and departing slamming doors as she went. At one stage she had the gas fire lighter which I use to light her candle at night. She was switching it on on and off, waving the flame near my face and threatening to burn me. In the end I grabbed it and snapped in half to prevent her using it again. I had decided not to respond to Margaret's abuse and kept my mouth shut and this seemed to infuriate her more. I knew that if I responded I could lose my temper and the way things were going get violent. I finally got to sleep about 2.00 am this morning.

And that is why I haven't blogged for a while. There is no reward when the person you care is totally selfish, abusive and thinks that you are a nasty evil lying bastard.

Friday, March 5, 2010

A Wet Few Days

I signed off on Tuesday saying that it was going to be a wet day. It was and so were Wednesday and Thursday and today more rain is forecast. South East Queensland is saturated. We are OK having only 220 mm of rain over three days. Some areas have had that in three hours and are flooded. Louis has been having a ball as there are some deep pools in out local park which he loves to play in and he comes home looking like a happy drowned rat. I rub him down in the garage and he the lies on a towel at the foot of Margaret's bed to dry off.

This has all meant that we have been literally confined to the house most of the time. I have spent the time putting together a little tutorial on using Wiki on a Stick (WoaS) to generate a portable Wiki page. I hope to present this tutorial at the computer club in a couple of weeks time.

Margaret stays in bed most of the time except for dinner and a little while afterwards. She is much the same, confused about dates and a really bad short time memory loss plus continuing incontinence. I am taking her for a blood test later today and will get the results next Tuesday.

One interesting thing about her behavior is her making up stories which become real life to her. I hope K doesn't mind but this is an example. K and Margaret have been friends for fifty years and in happier time communicated by e-mail sending each other jokes. Because of Margaret's problems and K's personal life this communication has been disrupted. Recently K has tried to forward some jokes to her and these have given rise to a real problem. Margaret thinks, based on absolutely nothing other than disrupted communication, that K is being isolated from her by his family who are preventing him communicating with her. she believes that K has set up an alternative communication method by getting another friend to relay messages.

The last e-mail contained an attachment in the form of an e-mail with a video video titled "Do You Know Who I Am" attached to it. Unfortunately the video didn't play. I have actually received it attached to another e-mail so I explained to Margaret what it was. Margaret doesn't believe me. She knows that the forwarded e-mail is a request from the original sender, a woman, to set a up a clandestine communication route to K. I pointed out that K had sent the parent e-mail and the attached e-mail was just that. She has spend hours trying to contact the the "contact' to let her know that she does know who she is! Short of disconnecting Margaret from the Internet I don't know how to prevent her sending spurious e-mails to this lady. I hope K understands.

Tuesday, March 2, 2010

More of the Same

Friday lunch was a complete success. Margaret had decided that we should try an Indian meal for a change so we went to a restaurant we knew as Chutney Mary's in Noosaville but found out that it was now called Raj Indian. The only problem was that it hadn't got it's full liquor license and I had to pop down the road to buy a bottle of wine and a couple of stubbies of light beer. Luckily most wine bottles these days have screw tops so we could save what Margaret didn't drink for later. We could have have the lunch time special which looked very good value at $11.90 but we went up market and had Tandoori style meals. Margaret ordered a Tandoori Chicken and I had Tandoori Prawns. Actually we shared. We had some Garlic Nann and rice to accompany the main courses. It was a really good meal. We spent the rest of the afternoon resting.

Margaret wanted a sandwich for tea but I just had some more chocolate finishing the large bar off. We were watching TV while I got my UK Drama Series fix, Silent Witness, when Margaret quite suddenly got upset with me. I don't know what I had done but she stormed off to the kitchen to get her bedtime medications which she couldn't work out so I had to help her. I made sure that she got into bed OK and went back to the TV – thank goodness for a time shifting DVD recorder. Later I had to help Margaret get back under the covers before I went to bed.

Saturday was a pretty bland day. Washing and house work. Margaret appeared to have forgotten that she was annoyed with me and we had a quiet day. I should point out that Margaret is now pretty much bedridden and still having “accidents” when she loses the race from her bed to the bathroom but this in now part of normal life for us now. She also has a really short memory span and conveniently forgets how many alcoholic drinks she had had. This gave rise to a funny incident Saturday evening. Margaret had been drinking white wine from a cask and when she wanted to go to bed she said that she was going to fill her glass up. As she had reached her normal limit I got cross but she said I should stop bullying her and she was having another glass. Next she went to the kitchen and filled a large glass with chilled water!!. She never realised that I was worried about the grog.

Sunday – another quiet day with Margaret becoming more detached from real life. She only leaves her room for dinner of when we have to go out. She never knows what day it is and I have to tell her several times a day. She also wants to know when her next medical appointments are. These are written on the calendar but as she doesn't know the day of the week or even month of the year this isn't much good. A typical conversation is:

Margaret, “ When do I go and see A (her GP) again?”
Brian, “Not until Tuesday week – March the ninth but you have a blood test next Friday.”
Margaret, “Why do I need a blood test.”
Brian, “A asked for it to see how you are going and to check your kidney function.”
Margaret. “When doe I get the results?”
Brian, “When you see A the Tuesday after?”
Margaret. “Do I have an appointment?”
Brian, “Yes.”

and so on.

This will be repeated at least twice a day.

In the evening little Louis was fast asleep on the settee with his head under on of the cushions which he finally pushed on the floor giving himself a fright. We both had a good laugh at his surprise and left the cushion on the ground. About an hour later Margaret wanted to go to bed and when she got up she saw the cushion on the floor and asked how it had got there. She had forgotten Louis' little episode earlier.

Monday I went shopping early after Louis walk and getting Margaret's breakfast. While driving between one shopping centre to another my mobile phone rang. I pulled over but the caller had hung up. It was Margaret. I phoned home and got no reply so I phoned her mobile which she is supposed to carry at all times. Again there was no reply. I drove straight home to find Margaret in the bathroom with a diarrhea attack. She was OK but had phoned me to get her some Lomotil.

The rest of the day was quiet and we had a roast chicken dinner which she enjoyed.

Today Margaret has started with pains in her legs which is probably due to mineral loss causing cramps and she has had a nasty diarrhea attack. It is pouring with rain and it looks like being a long gloomy day confined indoors.

Friday, February 26, 2010

A Chocolate Binge

After Margaret's very unhappy and confused start the rest of Wednesday went quite quietly until after dinner. We have for many years been steady drinkers of Australian cheep wine but since Margaret's illnesses have progressed we have cut back quite a lot. Normally we share a bottle of wine over dinner and watching TV afterwards. This evening Margaret wanted more wine and I said that she had had her normal amount and she got very upset. First she called me a liar and other less complimentary things and of course Mr Cool here did his block. Margaret ended up raiding the fridge and filling her glass from the cask of white wine, which we use occasionally, spilling a large quantity on the floor and leaving it for me to clean up!. I told her she was on her own and stormed of to bed. Of course I had to go back and sort out Margaret's medication. Anyway we retired to our respective bedrooms not talking. Margaret slammed her door shut but I left mine open to make sure she was OK.

In the morning her door was still shut so I had my breakfast and took Louis out for his morning walk. When I got home Margaret wheeled herself into the kitchen and proceeded to make her breakfast but nearly lost the lot when she tried to wheel it back to the bed room. I carried her tea, water glass and medications back to her room but she was still ignoring me.

I went shopping and when I was out bought her a large hazelnut milk chocolate bar. On return I offered her morning tea and a biscuit which she refused. I was still upset and feeling very depressed. These arguments really get me down so when I have my morning coffee I had four big chocolate biscuits. I spent the rest of the day resting and watching TV - the Winter Olympics and Australia winning a Gold Medal. I cooked sausages and mash with onion gravy and green beans and peas. Margaret was not hungry and ate a little mash and half a sausage. Louis has sausage and mash for dinner today.

Afterwards I offered Margaret her chocolate bar but she would only have a small piece so I ate about half of the bar. Fortunately Margaret's mood improved and although she went to bed early she was quite quiet and friendly.

I should point out a couple of things. Margaret's tolerance to alcohol has dropped considerably since her illnesses have got worse and she becomes aggressive and has a tendency to fall over more frequently. I restrict my intake to the same amount as Margaret. I also have Type 2 Diabetes which i manage by diet and exercise which Louis helps out with. Four big chocolate biscuits and half a large chocolate bar are more that I have eaten in at least for years and total more that my normal years intake. My blood sugar readings weren't too bad this morning considering.

When I think of chocolate binging I think of Dawn French as the Vicar of Dibley going on a chocolate binge after her boyfriend dumped her. I think it did help a bit with my depression.


Today Margaret is back to normal so we will probably go out to lunch later.

Wednesday, February 24, 2010

Margaret has me Stumped

Yesterday I had a bit of a whinge about Margaret being unhappy and taking it out on me but this morning I saw how desperately unhappy she is.

I get up early, shower, shave and have breakfast before checking on Margaret then taking Louis for his morning walk at about 6.00 am. This morning Margaret was sound asleep so I left her and went out to meet J and her dog Jack for our morning walk. When I got home Margaret was lying on top of her bed in tears. I tried to comfort her but all she could say is that she wants to go home. After 51 years of marriage and living in this house for over 12 years which is longer than we have lived anywhere else I thought this was Margaret's home. It appears that in Margaret's confused mind there is a place that is really home to her.

I managed to give her some comfort and Louis jumped on her bed and laid beside her while I got her breakfast which Louis shares with her.

Yesterday Margaret's GP explained that while her blood tests were holding steady the continuing increased levels of toxins in her blood would be exacerbating her confusion and causing other side effects such as itching skin and watery eyes. These will get worse over time and she will continue to have blood tests every two weeks from now on and when the kidney function drops below a certain point she will have to go into hospital for hospice type care. As I have said before dialysis is not an option.

In the mean time I am determined to try and help Margaret feel that she is at home.

Tuesday, February 23, 2010

Margaret is Unhappy

I suppose the title is bloody obvious but I feel Margaret has become more and more depressed over the weekend.

Friday lunch was a letdown. The Bowls Club has decided to limit its menu to a few simple dishes at a rock bottom price with a few more expensive specials. Neither menu included Margaret's favourite, Sizzling Garlic Prawns. We decide to go to another restaurant near the river called Maddisons. Here were had a fairly expensive meal with Margaret having a chicken on a Turkish bread roll while I had fish and chips. At least they were nicely presented and well cooked.

The rest of the afternoon Margaret spent resting but she woke up hungry so I made her, the old standby, cheese and tomato sandwich followed by a fresh peach. Margaret did not want to stay up and went to bed early. At about 10.30 pm I looked in on her to find her sitting up on the side of the bed. She was quite distressed and said that she couldn't get to bed properly. I managed to straighten up her bed and get her to lie down but she took some time to go to sleep again.

On Saturday Margaret woke up in an upset state. She is becoming more and more confused about what day it is and was worried that she was missing some appointment or other. She relaxed when I told her it was Saturday and that she could relax all day.

Saturday looked like being a fine day so I decided to only do the washing and spent the rest of the morning mowing the lawns and tidying up the garden. Margaret got quite upset with the noise of my little push mower which is really quite quiet and slammed her bedroom window shut. I split the mowing into two periods and had morning tea in the middle. Margaret wouldn't talk to me nor have a cup of tea.

After finishing the mowing and a couple of loads of washing I asked Margaret what she wanted for lunch and she said that she didn't want anything. Apparently she had had an "accident" which she had cleaned up but she still had pains in her tummy. I asked if she had diarrhea which has been getting recently. She confirmed this and I gave her some Lomotil to settle he tummy down. These are prescribed for this sort of event but have to be used sparingly after diarrhea. I managed to get her to eat a sandwich with Liverwurst and tomato and she rested for the rest of the afternoon.

Margaret had said that she wanted a portion of cold roast chicken for dinner with salad and fruit so I had bought half a roast chicken from the local supermarket. Margaret chose the breast and then after eating the wing left the rest! Louis had the rest the following day for dinner - have I said that he is getting fat?

After dinner Margaret again went to bed early has she still wasn't really talking to me. I managed to delay her taking her tablets until about 10.30 pm which as they include a sleeping tablet meant that she slept most of the night.

Sunday morning she woke in a foul mood and why shouldn't she. I can't see any reason for Margaret to be happy. She is is in constant discomfort in spite of the morphine patch. She has continuous diarrhea causing incontinence and has little or no energy due to her failed adrenal glands and failing kidneys. The problem is that she has only me to take it out on.

Sunday morning I changed my bed linen and put them into wash while I did the house work. I dusted throughout, vacuumed the floors and washed the tiled floor areas. I also cleaned both the bathrooms so by lunch time I was knackered and just wanted to relax in front of the TV. In the middle of the housework I had to help Margaret following two messy "accidents" but Margaret had other ideas, she wheeled herself into the lounge and demanded that I change her bed linen as well. I managed to defer it until after I had walked Louis later in the afternoon. She actually watch the complete first series of "To the Manor Born" during the day but i don't know if she took it all in.

I asked her what she wanted for dinner and she said nothing then changed it to bread and butter and a peach so I gave her that. I had an egg and bacon sandwich which made Margaret very angry. I asked her what she really wanted and she just said that she didn't want eggs or bacon and I told that's what she had - an egg and bacon sandwich less eggs and bacon. She was not amused -once she would have been.

She had another early night.

Monday was more of the same - angry and "accidents". I manged to get her to eat a full roast dinner but by 7.30pm she was angry with me and I don't know why so she took herself of to bed again. I haven't seen much of her for the last few days and when I have she has been angry with me.

Today Margaret went to see her GP to get last Friday's blood test results. They are much the same which is good.