The Overview (Wed May 26, 8:30am)

It occurred to me that some people reading this blog might not be aware of mom's overall status, so I thought I'd just give the "big picture."

Mom has one artificial heart valve (done in 2001?), and the valve on the other side is leaking. This is causing fluid to accumulate in her tissues (a.k.a. congestive heart failure). The excess fluid causes her heart to have to work harder, and I think I also remember hearing that her heart is enlarged because of this. She is taking diuretics to eliminate the excess fluid. The diuretics tend to dehydrate her, but the flip side of that coin is that when she is dehydrated her kidneys don't function as well as they are supposed to. (Kidneys work much better when there is plenty of water in your system.) So there is a very precarious balance between keeping the fluid low so her heart works better, and keeping the fluid up so her kidneys work better. In fact, when she landed in the ER back in April what happened was that she had been taking an antibiotic to try to heal the sore on her shin, and a very common side effect for many antibiotics is nausea. When she got nauseated, she stopped eating and drinking, and consequently she got dehydrated, which caused her kidneys to fail. The eventual diagnosis after her week in the hospital was kidney failure.

Mom is on a whole slew of medications to control all kinds of metabolic processes, and the whole thing is in a very delicate balance because one medication may cure one thing and cause an effect in something else, which then has to be counteracted with a different medication.

Now we are beginning to suspect that a slow heart rate is what is causing the spells. I found out yesterday that one of her many meds is one to slow her heart rate because a month ago it was racing and continually over 90 beats per minute. Well hopefully the Holter monitor will tell us whether that is the problem.

Mom is unable to drive because of the spells. Fortunately she acknowledges this, although she did say that she feels OK about driving in Rocky Point, just not on the highway or to town. Personally I don't even want her driving in RP, because she could just as easily run off the road or into an oncoming car on Rocky Point Road. Not being able to drive is a serious hindrance, especially when you live 40 miles outside town, so she really needs someone with her.

Mom is just skin and bones. Her little arms are about as big around as a toothpaste tube. She has very little muscle, and even has trouble lifting a half-gallon carton of orange juice. Even if she had a ride to town to get groceries, it would be a monumental task for her to get them down from her car and put away. She has so little energy that by the time we are back from town, it is all she can do to get down the hill and into the cabin.

One other thing that kind of indicates her degree of decline is that she is now allowing me to load the dishwasher! I cannot remember her EVER permitting anyone to load her dishwasher...she always insisted on doing it herself because nobody else did it right. Now after dinner she is content to sit at the table while I clean up, including loading the dishwasher.

She is frustrated by her lack of energy, but I suspect that it's not going to change, since the probable cause is her heart condition. Her mood varies depending on how worn out she is feeling. Sometimes she is her normal cheerful self and other times she is very cranky and tired. Mom has great faith in doctors and she thinks that "they will figure this out" and at that point everything will go back to normal. I kind of have my doubts about that.

We are heading to Medford in about an hour to visit Dr. Kim, her primary care physician (Internist, I think). Then she wants to stop at Costco so she can stock up her freezer, then back to RP. Then depending on what time it is, I either have to hop on a conference call, or do a speed run to KF to drop off the Holter monitor to get back in time for my conference call.