New Subject

Up early to read and plan my day. New subject to deal with today, extra nutrition for Bob.

First did another call to cardiologist since Lasix dose is not taking enough fluid off him. He's short of breath and unsteady on his feet. Likely cardiologist will increase dose and have me continue. Waiting call back on that subject.

Second, made appointments for flu shots. Got to keep up with all the immunizations they want us old folks to have.

Third, talked to sister-in-law about her painful hip and back. Told her to do what the doctors recommended or keep that subject to herself.

Fourth, began researching extra nutrition for Bob. He's continuing to lose weight. Called anti coagulation lab to see if any truth to what I'd read that people on blood thinners should not use commercial high nutrition drinks because they often do not play well with blood thinner medications. Yes, that is true because most of them contain vitamin K. Can use those drinks but must notify lab and take him in for blood tests to see how it's affecting his clotting numbers. They will adjust medication accordingly.

That seems like a lot of trouble. Suggested I make high nutrition shake at home, and maybe add protein powder. Nope, they're also concerned about how much protein he's getting.

Taste buds don't work as well in the elderly. They often begin to crave spicier foods, and like the taste of salt and sugar. If you visit a nursing home at mealtime you will often see workers opening packets of sugar to sprinkle over patients' food trays. They may not know what they're eating but will enjoy the sweet taste. Other things that affect appetite are medications and dementia.

This afternoon I'll be researching juicing, high nutrition shake recipes, extra nutrition through snacks and hiding foods from a food processor to regular recipes. Probably need to move to several small meals a day rather than normal three.

I'm thinking having him in the kitchen may be a problem because he will see when I'm slipping in extra nutrition and may disapprove. If he doesn't see it, will probably never know it's there.

This is all very opposite to what I need to be eating. He'll never remember to eat multiple times a day because that will be new to him. He can still do a little cooking if it's an old recipe with few ingredients and directions. Anything new will be beyond his ability.

Have call in to hospital education department in hopes they'll have some recipes and suggestions for me.

I'm feeling a little overwhelmed. I can be nurse and caregiver, I think I have a handle on that. Nutritionist  food shopper, and cook, not so much.

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.