The Nightly Check-List

It’s varied a bit, over the past year or so, some things no longer need to be done, others get added in. This, then, is the current list of things to do to help mom get ready for bed:

1. Test her blood sugar level. This, because, as I’ve mentioned before, it helps eliminate those nighttime low-blood sugars. To do this requires a wet cloth, to wash her finger before doing the finger stick, then testing the blood, changing the needle so it’s clean next tim eshe has to do a finger stick, taking the fast-acting insulin if she needs it, and taking the slow-acting night insulin.

2. Test the blood-pressure. Good pressure is especially important when you have kidney disease.

3. There are two fingers being treated for a skin cancer — this involves a salve, a cream, then a bandaid.

4. There’s a bump on her toe. She has decided that she needs cream and a band-aid on that (no salve, though — that’s for the cancer.)

5. Taking a blood-pressure pill.

6. Cortisone ointment on a spot on her back. The dermatologist sees nothing there, but, it apparently itches, so it needs ointment, or it itches all night.

7. Changing the bandage on her face. She had two skin cancers burned off about 10 days ago, and these need to stay slathered in cream and covered with a bandage for two more weeks. The bandage is changed nightly, and the burned area is washed well, before being re-covered.

8. Placing salve in each eye, to help with the dryness that’s a result of the eye-lid surgery.

9. Putting Vitamin E oil on her eyelids, to help with the scars from the eye-lid surgery.

10. Making sure the phone is by the bed, in case she needs to call me during the night.

11. Making sure the tv is on, and the sleep-timer is set for 2 hours.

12. Saying “Good Night. I Love You.”

Mom, Make-up, Those Shoes, and Lonely Silence

My mother was 42 when I was born. My memories of her for the first few years of my life are rather vague and nebulous. It’s probably safe to say that I am unable to comment, with any firsthand knowledge, of the first 45 years of my mother’s life. But, for the 40-some odd years of mom memories that I do remeber, I can confidently claim that my mom is not a girly-girl. Oh, don’t get me wrong, I’m not criticizing her. Just stating fact.

I can remember quite clearly how excited she was when the school district she taught for decided that it was alright for their female teachers to wear pants, rather than a dress every day. Ever since then, the only time mom wears a dress is for weddings, funerals, and certain special occasions.

Liberated she might have been, wearing those pantsuits, yet, she never got too liberated: she never burned a bra.

Now that she’s 88, she can’t do the things she once did, but, back in the day, my mom built and finished the cabinets in one of the bathrooms here in Chez Xanadu, she sanded and finished most of the built-ins in the house, she pounded nails, turned screws and sawed wood while the cabins in the mountains were being built, and she knows a few tricks about electrical wiring. She never wore her fingernails long, or painted them, as the paint would just chip, and the nails break during hard work. She wore a chipped nail, or a bandaged finger, as if it were a medal of honor.

And, let’s not forget this:

How many people can claim to have a photo, taken in the 1950s, of their mom on the rifle range, where she became a qualified marksman?

My mom’s never been into makeup — she had one tube of lipstick, and a couple of samples of other lipstick colors that she’d gotten at some Avon party, and that was all she owned for years. The tube of lipstick may have held the record for World’s Longest Living Lipstick — it resided in her top dresser drawer for my entire childhood, and was there when I moved out. She called me one day, I think I was in my early 20s, and told me she’d thrown out all her lipstick because she’d read an article that bacteria grew on the lipstick, and shouldn’t be used after a certain period of time. If it hadn’t been for that article, I have no doubt the tube of lipstick would still be there — only very special occasions warranted lipstick; being worn only once a year, a tube of lipstick can last a lifetime. Other than the lipstick, my mom has never worn any other makeup. I remember one time, she went to some makeup party, and came home with a new look. She showed us, we all made suitable noises of approval, then she went to the bathroom and washed it all off. “I’ve never had the patience to stand in front of

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Mom, Diets and Nutritionists

“I should have just told them not to replace the heart-valve, and to just let me die, then you wouldn’t have to be inconvenienced about anything.” This from my mom, who’s always lived by the rule “If you can’t be melodramatic, then why bother?”

Here’s some relevant information, to bring you up to speed:

In December 2009, about a month after her heart valve-replacement surgery, we had an appointment with her Nephrologist (translation: kidney doctor.) Mom’s been seeing him for almost a decade, as she has Chronic Kidney Disease. During this visit, her blood-work revealed that her Phosphorous levels were high, and the doctor gave her a list of foods to be careful of, to not eat too much of. On subsequent visits, I followed-up with the doctor about her Phosphorus level, and he would tell us that whatever she was doing was working — her levels were good. (In all honesty, we hadn’t changed much, since the doctor figured it had to do with the effects and aftereffects of her surgery).

Another piece of relevant information:

Over the past few months her blood pressure has been quite high, resulting in a 4-day stay in the hospital last month, various medication changes, one of which caused her to swell like a water balloon; the end result being a pill to help her get rid of all the fluid she was retaining (about 15 lbs, it turns out). The pill works by making you pee a lot, and, along the way, it depletes your potassium. During the most recent visit to the kidney doctor, he put her on a potassium supplement, because her potassium level was low. He felt it was temporary, due to the water pill, which she had stopped the day before, because the fluid had all been peed out. He suggested some foods that would help raise her potassium levels, requested a blood test in a month, and told her not to worry, it probably wasn’t a long-term issue, just an imbalance because of the water pill.

Yet another piece of relevant information:

Last month, while mom was in the hospital trying to get her blood-pressure under control, they discovered that she had atrial fibrillation. She’d had a-fib after her valve-replacement surgery, but, her heart beat regulated after a few months. It seems that it’s back, and, probably was there still after the surgery, just not as intense as it was after the surgery. A-fib is one of those conditions that, depending on the severity, and on the individual can be noticed by the patient when it happens, or the patient will never feel the fibrillations, so it can be hard to detect. Being hooked up to a heart monitor while she was in the hospital brought the condition to light. As a result, she’s on Coumadin, a blood-thinner, that will keep her blood from forming clots in the chambers of her heart. Blood pools a bit during an episode of a-fib, and, it can form clots, which can then be pumped out of the heart, and the clot can end up in the brain causing a stroke. The Coumadin responds to Vitamin K, which is present in green vegetables, and certain other fruits. So, you have to regulate your intake of these foods, because they can make your blood too thick or thin.

Final bit of relevant info:

My mom likes to be the center of attention. So, yes, it’s fair to say that we all have our moments where we desire to be in the spotlight, but, with mom, it’s more than our own basic need for recognition. My mom cannot bear to have a conversation that doesn’t somehow include her for very long. If people are talking about things she doesn’t know, she’ll change the subject back to her. If there’s a story being told, my mom will always have a better story about herself to share. She’s always been this way, but, as she’s gotten older, this tendency becomes more and more apparent. I suspect that part of it comes from having outlived most all of her friends and her generation of family, leaving her with few people to talk to regularly, so, now, when she gets the chance to talk, she can place herself firmly in the center. This has the unfortunate side-effect of impairing her listening abilities. She’s so focused on her part in the story, that she hears only selective parts of what anyone else is saying.

Yes, yes, I know… not the most exciting information in the world, but, it will add to the story, and, let’s be honest, when you’re writing, certain backstory information is always going to be mind-numbingly dull. Thank me for getting it out of the way at the beginning.

Now, onward to the story:

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The Vindication In The Low

Vindication, when it comes to us, brings with it a superfluous sense of self-righteousness which then manifests itself in a satisfyingly smug “I told you so” smirk.  When vindication does not favor you, but results in someone else directing that satisfyingly smug smirk at you, it seems as if said smug is in the worst possible taste.

Case in point:

My mom is a diabetic, has been since the 1980s.  It’s only been in the last decade that she’s been on insulin, rather than pills.  The insulin gave her much better control over her blood sugar levels. She was very serious, very diligent about testing her blood and taking her insulin until she had her aortic-valve replacement surgery two years ago.  Since then, she’s been fairly lax: testing her blood only once a day, only taking once a day the insulin that she’s supposed to take with every meal. We’ve gone round and round about it, and things finally came to a head last week.

She called me at 3:46 a.m.

I had not yet gone to bed.  I gave up sleep one year for Lent, and have yet to return to the regularity of a 7-8 hour a night rest.  The phone ringing was not as startling as it is when one is asleep.  Though, it should be said, that anytime an 88-year old parent calls in the middle of the night, it’s upsetting: there’s usually something wrong. On this particular night the news is that her blood-sugar level  is low, and she needs juice.

If you’re unfamiliar with diabetes, the only thing you need to know at this point is that a low blood-sugar level is not good, and,  if not rectified quickly, can result in serious consequences, and could even lead to death. I’m happy that my mom is aware of her lows; there are many diabetics who have no idea when their blood-sugar level is low, and this can make things much more complicated.

I made my way into the kitchen, poured her a half-a-cup of juice, adding half-a-packet of Equal sweetener to the juice, since fruit juice is never sweet enough for her, and brought the doctored-up juice to her room.

She was half-sitting up.  Not only did she look like someone who was abruptly awoken from a sound sleep, but, she also had The Look.  The Look is rather tough to describe in a few words.  The Look is what she gets when her blood-sugar goes below a certain level; it is a look of Differentness: her skin, while not pale, is not quite as colorful as usual; her eyes seem to just be slightly unable to focus, so she squints ever-so-slightly; her speech, while not slurred or jumbled, is just different — to someone who wasn’t familiar with her speech, they’d probably not notice, but, to me, who is so familiar with her voice, there is this slightly strange difference to its tone and cadence.  The Look seems almost as if she’s faded slightly.  When I see her with The Look, I know that her blood-sugar is going to be really low.

As she is drinking the juice, I get out her blood-testing kit, place a testing strip into the machine, give her a damp washcloth to wipe away any possible sugars on her finger, as these could add sugar to her blood and give a false reading. I hand her the needle to stick her finger, which she places it against her left ring finger, and then presses the release.  The needle shoots out, pricking a small hole in her finger, and a second later, a rich, red blood droplet appears on the tip of her finger.  I put the test strip up to the blood drop, the meter beeps, indicating it has enough blood to sample, and within a few seconds we have the result: 45.  A good blood-sugar level is 70-100, while less than 70 is considered low (the lower the number, the more serious the low).

I hate when the number is in the 40s, as that’s when bad things have happened.  She gets quite belligerent when her blood-glucose level is that low, resisting and arguing every step of the way (for many diabetics, this is a common side-effect of low sugar). When she gets belligerent, she likes to insult me and call me names — during these episodes, she’s called me queer, homely, stupid, fat, whore, and, more than once, she’s called me a fag. One example: she was being very belligerent with me, and was refusing to drink any juice.  An argument ensued, with her telling me “I’m 85 years old, dammit, and I don’t need my fag son telling me what to do.  I got to be this age without any help from you!” I, in turn, told her that if she didn’t take the juice, I was going to call the ambulance, and that all of the neighbors would see her being carried out on a stretcher.  Even though mom loves to be the center of any and all attention, the thought of being carried out of the house, on a stretcher, in her night clothes proved to be too much.  She drank the juice. After, she had no recollection of the argument (this also seems to be common to many diabetics when they are having lows, this forgetfulness of what has happened. According to her doctor, I’m not supposed to take these words seriously, though, I cannot help but wonder if she is giving voice to thoughts she keeps buried, or if they truly are meaningless thoughts brought on by her condition).  Another time, when her blood-sugar dropped to 40, she couldn’t keep the juice down, and she had moved her emergency glucose needle (a syringe full of glucose, to be injected in just such an instance) and it was not in the place where it is usually kept.  The ambulance had to come that time.  Another time (though, this time her low was caused by her accidentally taking 20 units of the fast-acting, daytime insulin, instead of the 20 units of the slow-acting night insulin) we were up most of the night,feeding her toast, juice, and several other things, and testing her blood every 30 minutes, until….I’m not sure what the “until” was.  I just know that it was daylight by the time she was stable and we were able to sleep.