Wednesday, July 29, 2009

Mom's mental and physical state

Mom is just as nonverbal today as she was yesterday, if not more so. She's also acting a lot more confused: she doesn't respond with the same instinctive accuracy she had shown up to now (for example, she doesn't immediately let go of a spoon when I ask her to, so I have to pry it gently out of her hand). Mom seems increasingly caught up in her own world; interacting with her requires us to be directly in front of her, dominating her field of view. She'll nod when asked certain questions, but will seem to ignore others. I doubt this is deliberate; it's merely a function of her condition. Whatever the reverse of aphasia is, that's what Mom seems to be manifesting. With aphasia, whatever's inside the mind has trouble getting out because the channels are scrambled along the way. Whatever Mom has now is the opposite: our attempts to give her commands often elicit incomprehension. Signals are being scrambled on their way in.

We're approaching a point where, sometime in the very near future, it will be necessary to feed Mom by hand. Her ability to feed herself is eroding; she gets stuck in a cognitive loop whenever she finishes a bowl of soup or dessert, endlessly scraping the bowl's bottom with her spoon for no reason other than to scrape away. She can also become distracted by what she sees on TV; when this happens, she'll stop eating and stare, transfixed, no longer conscious of her meal. It takes some prodding by us to get her to refocus on her food.

Mom is also much weaker on her feet, and her balance is in tatters. She can still walk, but to walk with Mom is to dance with her-- I hold her by both of her hands, walking backward while she shuffles timidly forward. She still has a sense of humor, because she'll move her arms along with me if I pretend to swing them as if we're dancing, sometimes even smiling while we dance.

But it's not all fun and games. Another reason why I hold both Mom's hands is that it allows me to control her repeated attempts to grab at small items on tables and countertops. She's still as fidgety and grabby as ever; having just taken her PICC line out a second time, she's shown us that this compulsion never left her. If anything, it's likely to worsen.

A lot of this might be attributable to the effects of the radiotherapy. Tonight, Mom will also be restarting her Temodar. Along with affecting her blood count and increasing the likelihood of reinfection, the Temodar may cause nausea, forcing Mom to eat even less than she already does. Mom's appetite is often fairly healthy, but over the past few days, she hasn't been eating nearly as much, a trend that's likely to continue if she does become nauseous. She sleeps a lot more; in fact, she's been napping for nearly half an hour (it's 4:58 as I type this; the blog entry's time stamp shows when I started typing this entry). Her siestas are lengthening.

We need to know what's going to happen with Mom's PICC line-- whether it'll be reinstalled, or whether she has scarred the veins in her other arm as well, thereby precluding further PICC line use. Since Dr. Meister's office is now in charge of this aspect of Mom's care, we'll know more tomorrow. Mom won't be getting a new PICC line today.


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