Portland, Oregon

Portland, Oregon

Wednesday, September 14, 2016

Angst, Worry, OCD, or Dementia

Bob had a doctor's appointment this morning. On the way I noticed the leaves are beginning to turn and that is very exciting to me because fall is my favorite season of the year.

Angst, worry, OCD or dementia, I don't even bother to try to distinguish one from the other. Makes no difference. Whatever it is requires my attention in the same way, so I just deal with it and move on.

Bob is in heart failure and as it progresses he picks up additional problems that go with the disease. He's now retaining fluid, which is common in heart failure patients. It's a fairly new development for him. Yesterday I called the cardiologist for some guidance since it's now pretty clear this is here to stay.

My question was about managing Lasix (diuretic). It seems to me giving Lasix every day is probably not good if you can manage to do otherwise but what do I know?  I know Lasix drains the system of potassium because I have to give him potassium when I give Lasix.
1) How do I know when to give it?
2) How often do I give it?
Word back from the doctor was when he's gained 5 pounds give him Lasix for 3 days. If he's not returned to his base weight call him.

Seemed simple enough to me but boy did that throw Bob for a loop. The simple thing seemed to be to tell him not to worry, to just leave it up to me to manage it. He was having none of that. He was off and running. We are now into day two of angst over taking Lasix.

Off and on all day yesterday I explained the situation to him. He'd be okay for a while and then we needed to do it all over again.
1) What if I have a doctor's appointment on a day I'm taking Lasix?
2) Why do you tell me one day I need to eat more, and the next day say I need to lose 5 pounds?
3) Why take it for three days and not every day?
4) I can't read the scales (wearing his glasses would probably help).
5) Why is Dr. P (cardiologist) doing this when I see Dr. K (pulmonologist) for my breathing?

On and on it goes. Eventually he'll move on but I'm not sure when. Tonight I'll begin weighing him in his pj's, and I'll read the scales. That will give me a good consistent picture. I'm now in possession of the Lasix and potassium. I'll decide when he takes it.

What can I say, he's 84, in frail health, but still on his feet and moving. He's still walking unassisted (most of the time), still washes his own clothes, still attempting to cook, but that's requiring a lot more of my help, still able to take care of his own hygiene. I have good medical support. All in all, life is good.

17 comments:

  1. Do visual aids help Bob at all? Like writing frequently asked questions on a dry-wipe board that you can refer him to? I ask because it did work with my dad for a while in his early dementia and husband until he died. I would also suggest you make it point of calling it "five pounds of water weight", not just "You gained five pounds" helping him understand that's a trigger for the 3 days of Lasix. Glad you're taking all medication out of his control. Older people get themselves in a lot of trouble doing their own.

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    1. Visual aids, darn why didn't I think of that? Sometimes he tells me to write things down so he doesn't have to keep asking me. I need to do more of that! Sticking Post-it notes around would probably also be helpful.

      Also like the idea of distinguishing "five pounds of water weight."

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    2. Post-it notes might be too small because with Bob's habit of not wearing his glasses, you'll need to write big, large and dark.

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  2. Linda, while you may feel that documenting these days is therapeutic for you, you are providing a very real service for people in a similar situation (or seeing a similar situation in their own future).

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    1. I take ideas from any place I can get them.

      The expierences I had caring for my parents has been enormously helpful. So much of what I'm doing now with Bob is stuff I went through with my father because he lived with us and suffered dementia. Sometimes I honestly have to stop and think is it Bob or is it my father I'm dealing with? I doubt Bob ever thought he might wind up like his father-in-law one day.

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  3. Congestive heart failure can be pretty tricky to manage. Sounds like you've got some good guidelines from the cardiologist and a good plan for keeping everything on track.

    The questions, questions, and more questions. All trying to make sense of the changes in his world. Difficult I am sure for him to take it all in, and it requires the patience of a saint (you!) to keep on managing everything as well as you are. Hang in there Linda.

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    1. I agree that congestive heart failure is tricky. We're now entering a more advanced level of it. I need to do some research on what to expect at this level.

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  4. You have a healthy attitude about the situation. He has some irrational behaviour that's pretty hard to deal with.

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    1. One way or another I plan to see this guy through to the end with no regrets when it's over.

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  5. I have not been experienced to this kind of aging - yet. We are learning from you, and from some of your other readers who have experience.

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    1. It comes to all of us if we live long enough. I sometimes wonder what it's going to be like for me when my time comes.

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  6. I cannot begin to explain how much I think of you, Linda!

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    1. Thanks, it's nice to hear words of support.

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  7. You are an example of strength and determination. Your life is good because that is how you look at it.

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    1. I think it all goes back to my family and how I was raised. I was the only child of older parents. We lived in a small community. Always old people around that people were caring for in their homes. Lots of multigenerational families. Just part of life.

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  8. Goodness, your routine changes each day. You seem to be always scrambling to keep up with the changes. I am amazed and impressed at your attitude and ability to bend and adjust almost daily.
    Does Bob like mushrooms? They are a natural diuretic and might help with water retention.

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  9. It's good that you can look at the optimistic side. Looking the other way doesn't change anything, does it? With new challenges coming along all the time, you certainly do have good coping skills.

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