Mother and the Dementia Paradigm Shift

(Please note: this is a stock photo, not Mom's scan.)

This past Tuesday, Mother and I headed over to USF for her first-ever MRI.  She did wonderfully, and they got very good images, which they then handed to us on a CD to carry to our later appointment at the Byrd Alzheimer's Institute. After a nice lunch at Panera, we were able to make our noon appointment with Dr. Fargher with 10 minutes to spare.

While I waited in the lobby, Dr. Fargher escorted Mother back for an MMSE and evaluation. Afterward, it was my turn in the doctor's office to talk about the results. Mother scored higher on the MMSE this time than she did when we visited two years ago. This does not usually happen. What made the biggest difference was one item that last time Mother didn't even try, saying "I can't", that this time she attempted and got 4 out of 5 points for. I told Dr. Fargher that when we had visited before, Mother had only just started going to the Neighborly Care Network senior center, and for the past 1.5 years or so, she has been attending three days per week.

With the report Dr. Fargher had received from the imaging lab, and the CD I had in hand, we looked at the brain images together which showed some overall shrinkage (not uncommon given Mom's age), very little shrinkage in the areas of the brain normally connected with Alzheimer's, and a couple of spots indicating small strokes (ischemic incidents, for you medically-oriented family members). This indicates that most of Mother's dementia is actually vascular in origin.

We also talked about Mom's hearing loss, and the doctor mentioned that she had to resort to using a pen and paper to clarify some of the questions, and Mother was able to easily understand and answer, even doing fairly well on remembering a set of three words, after they were written down. The doctor suggested we keep a whiteboard handy at home for times when Steve or I didn't feel like we were getting an idea across. We decided that Mother's current meds were all good, and that there was no reason to set up regular appointments, but to call if any additional problems arose.

This really changes everything! 

The length of time from diagnosis of Alzheimer's to death is usually 3-7 years, depending on what stage the person is when evaluated. Since Mom's initial diagnosis for Alzheimer's-type Dementia back in 2007 (no MRI done at that time), I've been worrying about how I would handle her inevitable decline, starting with having to work part-time so I'd be home with her anytime she wasn't at the senior center, and of not being able to leave her alone even for short periods of time. I've been waiting for the horrible eventuality of Mom deteriorating into some mere shell of herself, not remembering anything or recognizing anyone.  

For vascular dementia, if the stroke risk is addressed, then relatively normal functioning can be maintained indefinitely. All this time, I just thought that her meds were working really well, as the decline we've seen is really minimal, and the memory loss patchy and not interfering that much with her daily functioning. (You don't really need to remember what a hush puppy is in order to fix yourself a sandwich for lunch.)

With the realization that a lot of Mom's seeming inability to grasp what we're telling her is probably directly linked to her hearing loss, my falling-off-to-sleep self wondered last night about the possibility of us all learning some basic sign language. I already know how to sign "thank you" and "good morning" - maybe Mom and I will start working on that today.

Morning Walks

Low energy. Low mood. I know, as a mental health professional, that the first, best offense against depression is to get one's heart rate up over 120, at least 3x per week. But I really enjoy being sedentary. I've actually developed a bit of a reputation among family and friends as being particularly exercise-averse. Partly due to all the icky sweating involved. *shudder*

Anyway, the mental health advocate in my head somehow overcame the websurfer office-chair potato and I found myself donning sweatpants, one of Steve's old Buc's t-shirts and my sneakers, with the crazy notion that a little exercise might not do me any real harm and could perhaps do me a little good. Bella heard the sound of the velcro on my shoes and came trotting in to see if this might be a dog-walking opportunity. Why not, I thought. I prepared a Responsible Pet Owner Dog-Poop Pick-Up Kit (a plastic grocery bag and 4 paper towels) and we headed out.

Day 1 of Walking with The Dog: 4/10 miles to the park, 4/10 mile back, brisk walk. My walking mantra: "Come on, Bella!" I worked up a little sweat and Bella was puffing a little by the time we made it back to the house. And no poop to clean up! Hooray! Maybe she does that at night!

Day 2 of Walking with The Dog: This time I decide to take a little longer walk, around the block and along the Mobbly Bayou walking trail, probably about 1.4 miles total. Shortly after we leave the house, she wraps her leash around a tree, and when I try to pull her back around it, she puts her head down and slips out of the harness. I pick up the harness, and after only five commands  to "Sit!", I get the leash attached to her collar. Before we are halfway through the walk, dog poop happens. Darn it! That's ok, though - I have my RPODPPU Kit from yesterday. I quickly clean up after her, we're off again, and I'm able to deposit the bag in the trash can at the beginning of the walking trail. We make it back to the house as Steve is getting ready to leave for work. I get a hug and a kiss and an "Ew! You're all sweaty!" I love you, too, dear.

Day 3 of Walking with The Dog: I get dressed, and Bella comes running when she hears the velcro on my shoes. She is impatient and starts talking to me about how slow I'm being. It takes 3 tries to get the harness on because she won't sit still long enough for me to complete the process. Short walk again this morning, to the park and back. I've replenished supplies in the RPODPPU Kit, which is good because just as we turn around at the park, doggie nature calls. All four feet on the grass, but with her butt hanging over the sidewalk, I give her a swift nudge to change the target to the grass, and just totally interrupt her mojo. Now she's spooked, won't be still while I clean up after her, and has grass hanging out of her butt. I think/hope that on the walk back to the house, she will get the urge again, but no, it's gone, and once we get home, I get to exhaust paper towels in my RPODPPU Kit wiping her and pulling the rest of the grass out so I can let her go in the house. She does not seem to find this any more amusing than I do. And I think I'm getting shinsplints.

These walks have really not been the meditative experience I had hoped. Maybe we'll both get the hang of it soon.

Travel Help Epiphany

I like to read. On long trips, I would like to read in the car. But until our most recent trip, I was never able to do so due to motion sickness. If the car is moving, I can't even look at the map for more than 30 seconds before getting queasy. As we were preparing for our recent Thanksgiving Trip To Texas, I remembered the medication I had gotten for a bout of vertigo several weeks ago.

Bonine is an antiemetic marketed to combat motion sickness. It worked beautfully. I was able to use my cushion-backed lapdesk for my daily journaling and also read almost all of The Huffington Post Complete Guide to Blogging on the drive home. I may never get to drive the truck, but when Steve and I hit the road next spring pulling the new travel trailer, I'll have lots of time for reading.

Soaking Up A Little Culture

Last June, Steve and I joined the Tampa Bay History Center when we went to see a traveling exhibit about Spies In America. We were somewhat underwhelmed by the Spies exhibit, but we had time to see part of the permanent displays before closing time, and had a nice experience. 

Today, we returned to see their traveling exhibit about coffee:

As we entered the building, I started up the stairs ahead of Steve, and he noticed that I was exposing more than my thirst for culture and knowledge.

We made a hasty entrance into the gift shop and bought something to remedy my overexposure.

With the tail of this "Ladies 2X" (that my shoulders barely fit into), I was able to recover some of my dignity as I covered my flanks.

We proceeded to the Columbia Cafe that is inside the History Center building, just outside the exhibits entrance, and had a nice lunch while we watched the cruise ships move along Channelside. 

The Coffee exhibit was small, but interesting. I had always thought coffee was a new world crop, but it is actually native to Ethiopia and was imported to South America as part of the triangle trade. We also learned how very labor intensive it is to bring a coffee crop to market. Coffee plants don't have a specific harvest period, with plants bearing flowers, green berries and ripened berries simultaneously, necessitating hand picking of ripened berries on a near-daily basis. The berries are then fermented to remove the fruit exterior, then dried, then shipped around the world to be roasted at destination. 

There's probably more to it than that, but I was already distracted by the next display, which was some kind of electronic scent module in coffee bags. When you squeezed the coffee bags, the scent of that particular kind of coffee was emitted. There were only two bags, but one was for Ethiopian coffee and one for coffee from some other part of the world. It seems that the soil and growing conditions play a great part in the flavors of the different coffees. I am afraid that that distinction would be lost on me in my normal coffee consumption, however, as I add flavored syrups and a lot of half-and-half to my coffee cup each morning.

On our way out, we stopped in the gift shop again and I bought a small bag of dark chocolate- covered espresso beans, at which point I found out that our membership allowed a 10% discount on gift shop and cafe purchases.

It was too late to get the 10% off our lunch, but the young woman kindly offered to refund and re-ring my emergency t-shirt purchase in order for me to get my discount. As members, we also get parking validation 3x per year, which saved us an additional $5 in parking.

As we were leaving the History Center, we decided to have a look at all the little vendor booths set up along the river walk. It turns out that today was the Third Annual Tampa Bay Veg Fest sponsored by Florida Voices for Animals. Several animal rescue organizations and groups promoting vegetarianism and veganism. We spoke to no one of the bacon-wrapped filets from Surf and Turf Market we had waiting at home for dinner. 

Dream Cogitation

As I was waking up Sunday morning, I found myself working on a comparison/contrast of psychology, sociology, and anthropology. I have no idea what I might have been dreaming, but it was enough to keep the thought process going even after I was fully awake.

Here's what I came up with:

Psychology is the study of individuals and how they have been shaped through their internal chemistries, their thoughts, and their interactions with others, with the goal of helping each to optimum functioning.

Sociology is the study of people in aggregate, their society, and how the individual effects and is affected by the social system, also with the idea of improving both the aggregate and the individual functioning to an optimal level.

Anthropology is the study of other societies, remote in time, distance, or social strata. It does not seek to "improve" the society being studied (which could be construed as a type of contamination, and which it would be unable to do in historical societies, anyway), but rather to understand to the point that what worked and what didn't work could be applied to optimize the observer's society of origin.

Maybe the next part of this comparison/contrast would be the metaphysical, which attempts to understand the impact of forces that do not originate within the physical self or society. This might include what Jung referred to as the collective unconscious, what people of Western religion call saints, angels, God, or Holy Spirit (or Satan or demons, if that impact is negative), and what New Thought calls Spirit or Higher Self (with the belief that the negative is physically based and not external to humanity), among others.

I still have no idea why this was important enough to make the transition from sleep to wakefulness, but after thinking about it off and on all that day, I thought I'd share.

Manifestation Madness

A few nights ago at dinner, I asked Steve for a story of recent manifestation. (I read a lot of Wayne Dyer.) He said he couldn't think of anything specific, but in general the right things come at the right times all the time.

I said that on the way home that night, I remembered telling him a few weeks ago that I wanted to live in a house where the toilet didn't gurgle when we did laundry. (The cut-rate plumber our landlord usually calls had assured us when it started making that noise after one of his snake-out-the-clogged-drain visits that it was making that noise because the drainage pipes were small and it was actually a good sign and that they were finally venting properly.) Shortly after my wish for a house with a non-conversational toilet, the drains in the entire house stopped up. The cut-rate plumber was not returning the landlord's calls, so he told Steve to make whatever arrangements were necessary and send him the bill. We called James of JHRooter in Oldsmar (727-420-1941). He arrived within the hour, brought along his very nice teenaged son as a helper, made everything ALL better, and after he left, we realized that now that the drain pipes for the house had been snaked properly, the toilet no longer talks on laundry day. Hooray!

The morning after our manifesting conversation, Steve came into the office to tell me that he now had a story for me. He was totally out of his fat-free salad dressing packets that he orders on-line. He was packing his lunch, resigned to the fact that he would not be having his preferred fat-free caesar dressing on his salad that day, when the FedEx truck appeared, bringing his latest order.

And that's how we roll at our house.

Yesterday morning, I realized that it was August 1st and the first day of camp. Woohoo!