Friday, September 18, 2009

visits, a stroll, and tomorrow

Mom had two visitors today: the Quiggs, who passed by to drop off a care package (thank you), and Mrs. Strausbaugh, who very kindly stopped in for a bit and left a full dinner with us. Dad mentioned some time ago that Mrs. Strausbaugh had enjoyed a reputation as an excellent cook when we lived in our old neighborhood way back in the 1970s; from the meal we ate the last time she made dinner for us, we know that Madame hasn't lost her touch in the slightest.

After Mrs. Strausbaugh left, Dad departed on a Korean store run and I took Mom over to Fort Hunt Park for her first real walk in several days. Mom has been getting steadily weaker, and today she barely managed 60 yards. She bravely tried to chug along as fast as she could despite my urgings to slow down, but as she herself noticed, she ran out of steam after only a few steps, wilting like a time-lapse flower, and obliging me to support her with a hug as we shuffled forward across the asphalt. Mom chuckled at her own feebleness, but she didn't fall-- I didn't let her. I held her up, and turned her toward the car before her legs had a chance to give out.

We now know that this weakness is one of the side effects of Mom's Decadron, a corticosteroid that, according to the nurse practitioner at NCI, breaks down muscle tissue. Muscle atrophy, then, is what we can expect as use of the steroid continues. And here's a funny thing: Dr. Meister had tried to correct me when I associated Decadron with Mom's weight loss, claiming that Decadron causes weakness, but to me, the causal chain is pretty obvious: muscle atrophy means decreased muscle mass, which in turn means weight loss. This reference associates Decadron with both weight gain and weight loss, because a drug's side effects will depend on its interaction with each person. (The nurse practitioner at NCI had also noted that many people on Decadron get "thicker around the middle," i.e., they get fatter, gaining weight even as they lose muscle. Mom appears to be an exception, as she isn't gaining fat.) The above-linked online reference also notes loss of muscle mass as a side effect of Decadron. Come on-- get with it, Doc!

Watching Mom's downward progress is always painful, and today was no exception. She was obviously trying hard to maintain as quick a pace as she could, but she was also obviously weaker than she was last week. I have no idea whether Avastin will weaken her further, but if the present trend continues, it won't be long before Mom will be needing a wheelchair full-time, even inside the house. Of course, we've known this from the beginning, but foreknowledge and fruition are two very different animals.

Tomorrow, Dad wants us to go to the local Koreatown for the KORUS (Korea-US) festival. A recent check of shows that tomorrow will be in the mid-70s and sunny, a perfect day for just such strolling. We'll roll Mom around in her wheelchair and see what there is to be seen. That's what care means these days: affording Mom as many pleasant sense experiences as possible, allowing her to drink in the world.


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