Trial And Error
The difference a day can make! I must share it with you Dear Diary. I tell you all the bad so you deserve some of the good as well.
Yesterday’s serious concern about the mysterious red lump on the front of Hubby’s leg, led us to an emergency appointment with Dr. N. Not only was it apparently painful, but I was concerned that it might be related to his diabetes. My mind raced to other leg conditions I have witnessed. One friend’s leg-lump was cancerous and he not only had to have surgery, but also an eventual amputation. It is so fortunate to have a brain (referring to my own for the moment) – that always goes to the worst-case scenario. As Hubby had not fallen recently, there was no logical explanation for the swelling. His obsession with it, became my own.
Hubby wanted the doctor to make a house-call because he was afraid to be with many people in a waiting room. I explained that as we received our multiple vaccinations against Covid-19, we were safe to go. I tried (unsuccessfully) to communicate that one could not really impose on a visiting doctor’s precious time over a lump on the knee.
The doctor appointment concluded that the swelling did not appear infected and would probably recede. Dr. N. used the time allotted to administer some standardized tests which revealed Hubby’s further cognitive decline. While we were discussing some related issues, I just happened to mention that Hubby has recently been quite manic in the mornings. All the visits to my room to wake me up in the wee hours have indeed been getting to me. Dr. N. had previously suggested a new medication to help with a sound sleep. His night time medication has been working well, except that when it wears off, Hubby becomes so obsessive and agitated that it takes hours for him to calm down. Dr. N. concluded that it was the quantity of the medicine for sleep that was at fault. It needed to be reduced. Our usual reaction when a medication is not working, is to increase it, but medications which affect the brain can be quite different.
It is fascinating, that the same medication which can calm, and induce sleep in an excessive amount, can cause psychotic behavior. We ran into this once before and know it to be true. What is excessive for one person, may not be for another. I asked whether the medicine builds up in the brain with time, and apparently it does. Who knew? Dr. N. suggested that two days in the week, we administer only a half tablet before sleep.
It is impossible for anyone (even the best doctors), to know exactly which medication will fit which patient until they are tried. The dosage is also something which must be determined with great care. Getting the medications right requires effort from the care-giver as well as the doctor. Only someone living with the patient can monitor the results of the prescription. Hence it becomes our responsibility to observe and report back to the doctor before accepting that a prescription given, is actually what our loved one requires.
This is not the kind of doctor-family relationship which most of us are accustomed to. But then, dementia is not a simple condition and it requires much of the family’s energies to get the treatment right. Once we accomplish that, we find that not only is the life of the patient improved, but our own lives benefit as well.
When we returned home it was time for Hubby’s exercises. It is a daily routine of light movements which keep the blood flowing. Hubby holds onto our decorative railing in front of the stairs to steady himself. Violet does the routine with him, and they both enjoy it. During the exercises, Violet suddenly remembered that he had banged his knee against our metal railings when he was doing these very same exercises yesterday. She had forgotten the incident completely as it was not particularly monumental. Low and behold the resulting lump was not going to result in surgery, amputation, or Hubby’s eventual demise after all. It was a bruise like any other.
Whilst the doctor appointment had been unnecessary, the information about the link between Hubby’s nighttime medicine and his morning anger and aggressive behavior was precious. We cut his sleep pill in half and hoped for the best.
It was such a joy to open my eyes this morning, and see that I had been sleeping for eight hours without my nightly wee-hour visitor entering and asking “Are you awake?” (Yesterday I barely had five hours sleep because of his incessant early A.M. conversation.)
I stumbled into the dining room to be sure that everyone was actually alive. It was far too quiet. Hubby was reading the morning paper. I looked questioningly at Violet to see if all was well. She smiled. Hubby had been Hubby, still asking questions over and over, but calm. When she sat next to him to take his blood-pressure, he greeted her with “Good morning, lovely face!” In my world, this is about as good as it gets!