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Kismet, Fate Or Chance?

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When it comes to caring for the survival of another human being, dear Diary, I too have times when I feel that I am being bombarded from all sides and know not where to begin to untangle what is happening before me.

Just when I think that I have Hubby’s condition (cognitive decline – dementia with all its attendant problems) under control, I discover there is more that I do not understand. It was time to ask our family doctor whether Hubby’s condition now requires a form of hospice care. It is not a word that appeals to me because, I, like many others, think of hospice as being helpful in the days and hours before death to keep the patient comfortable. My patient is not in pain. I refuse to consider that he is close to death because my refusal means he will live longer.

His new issues have more to do with intense deep sleep, an inability to swallow food, an unwillingness to take pills (of which he has many), an inability to be roused from his slumber without at best, angry fists waving in the air to demand that he be left alone. Hubby has stopped asking about the time and checking his watch. As much as it made me a bit nutty when he asked the same question over and over, no questions at all is even worse. His watch was suddenly so unimportant to him that he took it off and put it into the pocket of his sweatpants. I know this because I heard: ker-thunk, ker-thunk, ker-thunk when I did the last load of laundry.

Actually discovering that his good chrome watch, which I bought him as a replacement for the gold watch that he lost, (Please read “The Watch” on thedementiadiary.com) had been through the wash cycle was absolutely the last straw. The back of my camel was broken. The tears welled up in my eyes over the stupid watch.

The truth is, that the other problems with Hubby were quite serious and I was trying very hard to stay cool about how serious they were. Just one straw too many!

After telephoning our family doctor, Dr. N, he asked me to speak with the private doctor, Dr. S., who comes to our home when we really need him. He is a geriatrician and would be more familiar with the home care services of our healthcare fund. I called Dr. S. and told him much of what was happening with Hubby, and he offered to come in an hour’s time. It really doesn’t get any better than that!

Following my own suggestions to others, I wrote down all of the new issues that concern me about Hubby’s condition. One by one we discussed them. We immediately discussed which tablets no longer need to be given to Hubby as he is now 95 years of age, and some medications really are not of value now. He is choking on many of them so we much reduce them to as few as possible.

Hubby said that it hurt him to pee yesterday. My first concern was whether he had a Urinary Tract Infection which causes many problems in patients with dementia. (Please read “The Dreaded UTI” on thedementiadiary.com). That was not even on my written list of the ten problems we were having with hubby recently.

Every time I see the word “pee” I begin to laugh. Not because I have the humor of a six-year old, but because it brings to mind a hand written restaurant menu with specials of the day which listed “Pee soup.” The owner of the Paris Cafe, here in Jerusalem was a friend of mine, not a native-born-English speaker, and I had to save him future embarrassment by telling him what I had discovered on the menu! Of course, I am digressing again… my one fault…back now to the important issues. Apologies.

Dr. S. happened to arrive while we were eating dinner. He said that it was bashert that he arrived at that moment. “Bashert” is a Hebrew word which also means “Kismet,” ”Fate” or “Divine Providence.” Take your pick, it is all one in the same! Dr. S. watched Hubby try to eat his yummy fresh baked salmon, only to choke on it and vomit it up minutes later. Hubby can no longer swallow properly. It is a very real condition which comes in the later years of dementia. The brain stops providing some of the involuntary physical responses, one of which is swallowing. When the food is not ingested properly, it can go into the lungs. This is called aspiration. The aspiration can cause pneumonia. Ignored or late detection of pneumonia can be fatal.

Immediately Dr. S. took Hubby’s temperature, it was quite high. We did not realize that he had an infection at all. Then his oxygen meter showed that his lungs were not receiving enough oxygen through the food aspirated into his lungs. Next the doctor listened to the lungs and knew it was likely that Hubby had pneumonia.

Everything was beginning to fall into place. A helpful hint from Barbara (me), for absolutely everyone reading this chapter: Whenever anyone in your household is prescribed antibiotics, save the few that are not used. Pay no attention to the expiration date. Pills are good for a lifetime, you heard it here! (Not capsules or liquid meds, just hard pills). No regular doctor would agree with me, however Dr. S. immediately asked if I might have any left-over antibiotics in the house. Of course, I did!! My pharmacy is complete. Hubby has had every pill ever prescribed, and I have tons of left-overs! We went through ten boxes of antibiotics before we found the specific one that Dr. S. wanted Hubby to begin immediately. I had three remaining tablets – enough to get us through the night until I could get the new prescription to a pharmacy. The pill I gave him immediately was possibly the most important one, because we caught the infection early and did not give it a chance to get out of control. Of course, everyone knows that antibiotics must be taken as prescribed and that even if the patient feels fine they must complete the prescribed dose and days, or the infection will not be destroyed and will return once again. Of course, everyone does not know, that is why I am telling you! So many people think that they are smarter than their doctors, and do not listen to their instructions! Bad decision!

Dr. S. shared that he had been to the home of another patient before he came to us, a wonderful woman of 100 years of age. By incredible coincidence, our family doctor (Dr. N.) was visiting the same patient. But our family doctor almost NEVER does that! He did come to us once when Hubby was in crisis, but I knew then that it was not part of his usual services. Thus, our favorite two doctors were with this special lady and discussing my Hubby, just before Dr. S. was about to drive to our home.

Truth be told, in my mind, it was far more than luck or chance. What were the odds that I would call both of our doctors on the same day? Or that Dr. S. would agree to come immediately? Or that he would run into our other doctor an hour before? Or that he would arrive while Hubby was eating to discover that he is aspirating and has pneumonia? Or that I would have the right antibiotic in my stash to help Hubby immediately? And if that is not enough, I have one more amazing tidbit to share.

When I arrived home, I discovered that Violet has collected the pieces of Hubby’s watch (which I mentioned had been in the washing machine creating a symphony of clangs). The flexible chrome wristband was in many pieces and the pins which held it together were scattered about. When I looked at the face of Hubby’s watch… the second hand was ticking away. It had the correct time on it. Who knew that the watch was actually water-proof? Even more shocking for me was the realization that the watch had actually been through not one, but two wash cycles. The recent load was only t-shirts (so no pockets for the watch), but Hubby’s sweatpants had been washed the day before, and the watch must have been in a pocket and thus made less noise being jostled about during the first cycle. It clearly fell out of the pocket and patiently waited for the next wash cycle to go “ker-plunk… ker-plunk.”

Experiences like these, where everything falls into place are not to be taken lightly. I will stop short of saying that there is a higher power looking out for Hubby, for fear that I might blame that same power if something should go wrong next time. Still, I have no problem feeling that it was all “Kismet, Fate or Bashert.” I will accept your choice unequivocally! You decide!


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Barbara Diamond is a journalist living in Jerusalem, Israel. She has been a political activist on behalf of Israel and the Jewish people for over fifty years, having participated in political and humanitarian missions to Ethiopia, the former Soviet Union, China, and Europe to meet with world leaders on matters of concern. She has written over 100 articles for the Jerusalem Post and on her blog at The Times of Israel, hosted an English radio talk show in Jerusalem and continues mentoring others to pass on the torch of responsibility. You can reach her at [email protected] and visit her site at thedementiadiary.com.