Tuesday, February 28, 2017
The Unexpected Phone Call
There is a hobby that some adults enjoy; adult coloring. I don't enjoy the coloring books, but I like the ones that are postcards or note cards. It allows you to get creative and share your art work with others. I'm not artistic at all, but with this, there are no right or wrong ways to express yourself. I like the colored pencils better than the pens, as it allows more subtle shading. The photo above is a postcard I just sent off to my mom. Kind of relaxing, and my mom seems to really enjoy getting them.
The last week or so I've noticed that Jim needs reminders to put used utensils and cups in the dishwasher. I was surprised the other day to find him simply rinsing or wiping off his fork and putting it in the drawer. It's happened a few times now, so I need to make sure I'm close by when he is fixing himself a snack, or something to eat. I'm real casual about it. As I see him ready to just rinse or wipe, I go over and say something like "do you want me to put that in the dishwasher for you?" It works. Just another change for us to adjust to.
Late last week, I received an unexpected phone call from Jim's physician (not the new one, the prior one). The call was prompted by the request for the transfer of records to Jim's new physician. As I've written before, I was never able to communicate properly/privately with Jim's physician. The size of his medical practice made it near impossible to speak with him by phone, privately, without Jim nearby.
(Background information: Jim never agreed to let me come with him to his doctor appointments. I think he was afraid I would mention my concerns about his memory. H also absolutely forbid me to ever say anything to Dr. C about any of these concerns.)
When Dr. C called, he called my cell phone. He had tried our landline, but obviously there was no answer since we are in FL. Perfect! When I realized who it was, I quietly said to Jim "it's my mom; I'll go in the bedroom to take the call".
Dr. C said the call was a followup to see why Jim was changing physicians. The floodgates opened, and I proceeded to tell him Jim's situation. Interestingly, he said he had noticed some minor issues with Jim's memory, and repeating himself, but he had not picked up on anything else.
I guess that doesn't really surprise me. The quick office visit to listen to your heart and lungs, draw some blood, do an ECG, would not necessarily lead to a conversation that would reveal significant deficits.
When I explained all of what is going on, he was shocked, to say the least. The conversation was a good one. He went on at length to offer help, referrals, whatever I needed, even if it was just to come over and talk to Jim.
What if this conversation had happened several months ago? Would I still have pursued the transfer of his care to a gerontologist? I don't know, and I guess at this point it doesn't matter. As I've mentioned in prior posts, I've already met with Jim's new doctor, so she is aware of his issues; I feel confident about her ability to work with me to help Jim with his anxiety and other issues.
As a new patient, the first available appointment with the new doctor is in April, which means we are kind of in limbo right now. Her practice recommends going to urgent care for issues that cannot wait until the first appointment.
I've mentioned in previous posts that we will fly back home the end of March. I've arranged for a friend to drive our car back home for us. This should minimize the stress for Jim to just one day, as opposed to 3 days. Our drive down was just short of a disaster. I am still left with worries about the flight out of Orlando, which is an international airport. It can be confusing and overwhelming even for the most astute.
After my conversation with Dr. C, it occurred to me that he may be willing to help me with an Rx for a sedative for the day of travel. Given that Jim is kind of in limbo, I'm not sure that he will be willing to do so. Technically Jim is no longer his patient. But his new doctor, who has not even met Jim, would be very unlikely to prescribe anything without seeing him first. Understood.
So, with a bit of trepidation I penned a letter to Dr. C, requesting help with a sedative for this one day of travel. Will he oblige? I don't know, but I am hopeful.
One thing that I do know (that I acknowledged in my letter to Dr. C) is that prescribing sedatives for someone with dementia is very tricky. Even something as seemingly benign as benadryl can increase confusion in those with dementia. Valium, a common sedative often prescribed, can also increase confusion with someone with dementia.
Sometimes a beta blocker (such as propranolol) is used; it slows the heart rate, lowers BP, and results in calm.
Dr. C knows Jim and his medical history, so I trust his judgement in whatever he recommends. It also occurs to me that he may decline, or that he may say that the risks outweigh any benefit from a prescribed sedative.
I don't know, but I figured it is worth a shot.
Well, another post is written and my heart is lighter. So many times I question my judgement about things. But I know that I am doing the best that I can and I need to make sure that I am kind to myself.
Thanks for stopping by. Sometime I think the the conversations we have in the comments section add a perspective that I could never provide. So for that I am ever so grateful 😊