What about it...bone time again...

         It was time for the annual Wellness Visit. Doctors do annual Wellness Visits that are not really 'exams'. For me that entails a fasting lab, and a short visit with the nurse who does the height-weight and blood pressure thing along with the long questionnaire designed to see how your ADL [activities of daily living] are getting along. 

There was a review of medications [right now, none for me] and a review of family history. 

The subject of osteoporosis came up and I came clean that I quit the meds after 2 months and didn't notify anyone. 

I won't be due then for another bone scan until 2025 which is fine with me. The Ibandronate made me so sick with headaches and nausea for 3 weeks after each monthly dose. On the 4th week before taking the med again, I felt pretty normal. 

[If I am not taking the medicine for Osteoporosis, the insurance won't pay for a scan except every two years.]

I have a history of sensitivity to medications. But I kept trying. After 3 strikes, I'd like to call it quits for the moment. 

I'm not in pain, I haven't broken anything, I even got run over by an E-bike and a woman and I came out with just a bruise.

We read the lab test, she asked how I am doing with being a caregiver.

------>>> 

We discussed the bone stuff. 

Here we are again. 

Discussing bone numbers. We discussed the 3 meds I've tried and not gotten along with. 

Of course Prolia was mentioned again. Pretty much because my medication choice has run out of options. 

I told Ann "forget it". 
She agreed that it was my choice ultimately. Then she discussed my results from last year once more. She urged me to call Emily and talk to her. [Emily is an Endocrinologist]

Her biggest point was again to point out to my that my LS [Lower Lumbar spine] scored a -4.8. The scale for Osteoporosis only goes to -5. Ann said she never had a patient with such um, alarming numbers.

Winner Winner Chicken Dinner!
I scored High!
Go Big Or Go Home!

Yet here we are.

I will call Emily's office and either make and appointment or talk with her via phone. 

My biggest concern with Prolia is that it may play badly with me. 

I've reacted terribly to all the bone meds so far. What happens if I start to have hypocalcemia with a 6 month shot in my system? I've had that before with the first med.  It is a critical emergency if that happens. Not all people have it happen, though. 

Prevention of hypocalcemia and by more lab tests. Yum, who doesn't enjoy a needle poke? Another place to monitor is the kidneys. Rut Roh. My kidneys have been flagged, so there is that. 

For 3 years they have been in the low normal range and now have dipped into the hmmm, range.

So what happens if my kidney numbers get worse with the meds? Um? Back to a med that caused me so much pain?

The really fun thing about aging is this. Your body ages, parts start to break down whether we like it or not. Skin gets wrinkly, joints get stiff, ... If only we were like old classic cars that could be rehabbed.

My lower spine got rusty. Unfortunately there is no body shop for spines. 

The issues with where the awful numbers are lies in my lower spine which supports by body weight and helps support my hips and legs. Eventually one way or another there will be a compression fracture in the low back. 

Eventually that causes a domino effect of compression fractures. 

It will happen with or without the medication in my opinion, since at this stage the meds can only maintain me at that low score. 

So I ask. What am I preventing? 

The bottom line is, I am not going to give up Hope. 

I found an inspiration just the other day from one of my older cousins. How much older? I'm not sure. She was a teen when I was a little kid.

I grabbed this from her FB page:

You are seeing it right. She is in Mongolia living with a family and learning to hunt with an Eagle from a Mongolian pony.

I would love to grow up just like her!

This is reality

Michael Douglas in the Movie Las Vegas:

"We were 17, you know, five minutes ago. It was just yesterday. I just don't know where it all went, you know? My brain cannot conceive how old this body is."

I had a conversation via text yesterday morning with a younger friend of mine who is trying to help her mom out. Her father had died suddenly he was a pretty active man. He mowed their 3 acres and did chopping wood for heat along with anything mechanical that needed fixing. He was the proverbial handyman at home. I suspect that he handled everything around the house which included the budget and banking.

Now the mom who is in her 70's is struggling to cope with everything left on her plate.

My friend said her folks never planned ahead, never thought out what 'might' happen if one of them left before the other. No plans. 

She knew we had installed a Mini-Split in our house and wanted to know if it heated and cooled. It does, but it is for 'single zone' heating and cooling. For us, that does our entire house. We have a small cottage.

Her mom's house is a very old farmhouse. You know, the type of old farm house that has slab dab additions and is two stories tall.

I asked my friend if her mother had considered selling the mini farm and moving to a smaller and easier place to keep up. To me, it is a no brainer. I can see the wisdom of it. But she has lived in their home for 30 years or more, I can see how hard it would be to let it go.

As a kid we lived in rentals, so I was used to seeing different homes and adjusting to different places. I think the longest we lived in one place may have been around 15 years. In my first marriage, we moved a lot. In less than two years we moved 7 times.

I never laid down roots in a community, but always adjusted.

I have lived on our place now for 28 years. At one time I could never ever see moving at all. Lately? I have thought about it a lot. My brain says I can do it all, and some days I can. 

Being a Caregiver for for 8 years has changed my attitude. I cared for MIL and watched as she lost the ability to drive, to make decisions, and to care for herself. It is a cold hard fact even though my Brain says it won't happen to me. 

In the blink of an eye one morning, I became the sole Caregiver to my husband.

Both of my parents downsized from the places they had. Dad got an apartment and loved the freedom he had from all the yard work and maintenance. He said it gave him the freedom to walk about and explore the new area he lived in. It made him very happy.

My friend said that she and her sister were going to have a sit down meeting with their mom to try and help her see reality. 

Sometimes I think long and hard about the changes that need to happen for me in the future. At one time, the thought of leaving my little farm was absurd. 

Country life is amazing. Except when it isn't.

There are very few if any services in a rural area. 

Now? I wouldn't mind a  small  tiny yard that would take me 15 minutes to mow. Or a place where I wouldn't have to walk a quarter of a mile to see if our gravel road was passable in the winter. 

A place where I could have groceries delivered, catch a bus, or walk to the nearest place to eat.

These are the things that I think about while sitting on the porch in the middle of the night with the moon shining and fireflies dancing in the pasture.

Things change. But we don't want them to.

Once upon a time...

Musing on Aging by Sandra made me think a little about how we change over all the years. We do age and it comes as a surprise to us in many ways.

Can we recognize all the changes we've had in our lives. How do we see aging now? Well, when I was in my 20's, 30's, 40's, and 50's, I didn't even think about aging. I was really just working, living and busy with other things in life.

When I was a kid. I didn't think about adults. Grandma Pearl was an old adult. I mean, Grandma's were considered old. That was just a fact. 

Me with the glasses at my Aunt's house, I think. Yes, I started life with bifocals.

School photo and shot that my dad took when my brother tied me up in the yard with jump ropes. Sometime in the 1960's.

I have many shots of me growing up, but that isn't the point. Here I am in the shot below in my early 20's with my firstborn son.

Years later with my first born grandson.

2020 during the Pandemic. Self portrait of looking out the window. I don't like photos of me, but this was done for a class.

Last 4th of July at the track with my grandson that was in the above photo.

I like the photos of me when I was young much better than the photos I have now. But it is what it is. 

Lastly, a shot of me this week at Mobility Class. We have all ages doing this together. Tory is next to me, she was the little girl who rode last week at my house.

The other folks are in the 40's and the gent is in his mid 60's.

How about recognizing those who grow older and change with age? Some folks change a LOT. Some don't.

 I looked up one of my previous foster sons just for kicks. I'd last seen him while he was in high school. He now runs a business and I wouldn't have recognized him at all except there was a photo of him on his SM page of his teen years. 

People change, some people don't change much.

Inside me? I don't feel changed at all. I can see the effects of aging outside on my skin and changes in my body. But in my mind I don't feel really that different. I seem surprised to find out that I am not quite the same person I was in my early years. 

I know people see me as aged and older. 

I used to freak out at photos of me that showed my wrinkly beat up skin. Funny, how we reach an age or reach an attitude where perhaps our once youthful looks don't really matter any more. 

I am who I am now and I am okay with that.

Be Truthful to your Doctor?

 

Are we truthful to our doctors? How has medicine changed over the years?

What is your doctor like? Do they listen? Do you hear what they say? 

I was having a long discussion with my elderly friend in the southern US. She grew up with old school medicine and seems to have an old school doctor. Or their healthcare is different in the deep south. 

My MIL was old school too. She didn't like to see the doctor and listened to her friends for medical advice quite often. If Silvia had The Gripe and took a particular kind of medicine, then maybe she had The Gripe and should take the same stuff. They traded symptoms and came up with solutions themselves. 

Later in her life, she decided that the More She Doctored, the better off she was. Especially if they gave her more pills to fix everything.

I'm guilty of what happens these days. I look things up on the web because we all know that we can cure ourselves on the web.

Some of the older generation never bother to ask the doctor what is going on or perhaps they are afraid of asking. Doctors know everything right? No, they don't. But sometimes getting a doctor to have a real conversation, is like a Mission Impossible Movie. 

My friend struggles when seeing her doctors. I don't think she interacts with her PCP. Or perhaps she can't remember what they were talking about. [She has told me that her memory is very bad.] When she tells me about her visit, she complains that no one told her a thing about her ailments. If she gets a new medication, she can't recall why and refuses to take it.

I asked her if she told her PCP about her frequent falls and dizziness. Or about the fact that she felt lonely and depressed?

Um, no, not really.

She said if she told them about her depression then they would call her mental and put it on her record. Therein lies a stigma. Depression = Mental? She is in her late 80's and won't share with her PCP because she feels she would be judged.

If she told the doctor that she has frequent falls they may think she needs help. She said she had dizziness and the doctor ordered blood work. She was angry because dizziness is only dizziness and she knows that her ears need cleaning because her Grandpa had flaky ears. It won't be in her blood work, she needs a specialist.

The last thing I discussed with my elderly friend was that it was okay to tell your doctor the truth, because they were not mind readers and couldn't figure out what might be ailing her if they didn't know she was feeling poorly.

"Do you mean you are truthful with your doctor?"

I was a bit shocked. "Yes ma'am. I do."

I studied for two years to negotiate the ins and outs of doctor visits so that I could code the visits with diagnosis codes for billing. Even I know that humans are incredibly interesting creatures that are still a bit of a mystery for doctors.

And yet here we are trying to find answers.

And yet there is the doctor visit. 

Sometimes it seems as if you are going 'round and 'round on a merry go 'round with no way off.

Humans are not straightforward in their thinking or their ailments.

Hey, I heard walking was good for you.... and....

Aging

There is something about aging that is great and wonderful and also so interesting and sad at the same time.

Of course none of us young folk ever thought that we would age. Surely we would never become like our Great Grandparents, Grandparents, or evenlike our own parents.

Oh what a surprise! My father would have been 103 if he were still around. My mom? How did she become someone frail and in her later 80's? 

My husband had warned me when we first met that he had severe health issues from his days in the Army and overseas. But we became soulmates and that cannot be changed by anything!

We forgot that aging would creep up on us too. I used to roll my eyes a lot when others would complain about their health or how many scans they did, or the meds they were on. Rich and I would wonder would we make that the topic of our everyday discussions?

We don't. 

Then Covid-19 arrived and I could no longer visit his mom twice weekly in the nursing home. It dawned on me that Big Berthie was lonely for family, even if she had forgotten about where she used to live and had lost memories she used to have...she never forgot about her son or daughter. 
She would recall that her daughter would call, but not recall why her daughter didn't visit.

She would talk to Rich nearly daily but not recall that he too, was a very ill person and had trouble getting out and about.

Some days I'd visit her in the home and she'd be asleep in bed. I'd sit in her room and read a book or return when I knew the staff would get her up for a meal.

I used to think that going into a nursing home to visit would be too dreary, too nasty, and maybe I'd catch something from all those folks I'd see in wheelchairs and laying in beds. Or simply by being there amongst all those folks too frail to live on their own that I'd catch Sadness and be Sad.

What I did find was the reverse. I found that visiting at meal time was actually quite enjoyable. There was laughter and jokes along with insane conversations that only could occur in minds that didn't connect to the Wifi. Or to put for others to understand, they had a bad sector in their hard drives [or brains]. Rebooting was not the solution. We just went with the flow.

Covid-19 has changed the very fabric of our social equation. Isolation for those who have health issues is more severe than ever. 

There is a strong divide between those that feel that Covid is nothing and those who feel that Covid is a threat to their very being.

My husband says he'd rather die of a heart attack than Covid. He never wants to see the inside of a hospital again. His experience on the Covid floor last year when he did not have Covid was insane.

He can remember that. The Bubble Heads and Space People in the middle of the night. The drugs and the nightmares.

So we set rules down. I get food and supplies. He stays home. He has always been a bit of a loner, but at an auction or other event like that... he used to be so sociable and outgoing. 

He does love company even though he says he doesn't. He doesn't want company because he doesn't want his past friends to hear him talk with Aphasia or see him struggle to breath. 

Seeing his daughter or grands or even his adopted 'kids' from Missouri make him smile and grin for days.

And so the other day... I was monkeying around with stuff in the kitchen and happened to have my camera near me. I turned and so this.

I leave you with this....

 

Where did it go?

Time, that is.

10 months ago, a self portrait in April of last year. Don't mind the messy table, it is always that way. Of course this is where we eat, discuss life, and hang out. It is my 'work' station and our dining area. 

This morning.

I don't like self portraits per se. Especially now that I can see how I have aged. I wonder why it is okay for guys to be aged with wrinkles and it isn't so cool for women?

I'm an outdoors person. Most of my time is spent outside in all the weather. I've beat the hell out of my facial skin. Hopefully wrinkles will come in vogue. You know those lines around the eyes and mouth. That ugly neck that everyone covers up with fancy scarves. 

I thought it would be fun to do some black and white work while I was in the mood.

Hands. My hands and how they have aged.
Once upon a time I looked at hands that worked in an office that were primped and polished. Beautiful nails and smooth skin.

Funny how I never saw the arthritic bumps and lumps and rough skin that are my hands now. But that is the progression of age and outdoor work. Our skin is the organ we all choose to ignore.

I remember being so impressed with my grandmother's hands. They were knotted, crooked, and bumpy. I recall standing with her as she used a scrub brush to get the garden dirt out of the cracks in her fingers. She was going to church and didn't want the other church ladies to see her rough hands.

While I was thinking about hands hubby sat down to cut up and apple. He didn't realize I could 'shoot' from across the table. The benefit of having live view and a flip screen. I set the camera to silent.

If I didn't know these hands belonged to my husband, I would have thought they were my father in law's hands. Age, medical conditions, and medicines all contribute to this dramatic change. 

I find it intriguing and curious. I see his hands while he is using them, but they look so stark when caught in a moment of time.

I'm making my mind up to get more comfortable with the looks of age. After all, I can't avoid it at this point. And I am not going to look suddenly younger. 
The face in the mirror is still aging even if I don't quite feel it on the inside.

Then there was this matter of going upstairs to clean up the room I'd left a mess with things scattered about. Suddenly, I found myself distracted. 

And amused.

I went to put some things away and organize some other things.

Ahhh. 

Well there you go. Another benefit of aging.

You can always give the excuse that 'my mind wandered' while I was upstairs.

Time keeps going. Funny how we are surprised at the changes we never noticed.

Life and death and decisions...

Frightful weather!

Overnight it snowed again. More snow/drizzle stuff. I spent about an hour last night cleaning out certain areas with a shovel. I had everything exactly how I wanted it and then...
it snowed again...and drizzled.

I saw an electric snow shovel on another blog I follow and thought that was the cat's meow until I realized that I'd have to keep it plugged in and a cordless one would operate for 25 to 30 minutes.
I almost considered a snow blower but only for about 30 seconds when I saw all the instructions and gas mixing stuff.
Ok, not a choice for me.

I'm still thinking of a little plowing machine type 4 wheeler job. It would get all the flat areas I needed cleared and a tiny bit of shovel work would do the trick. IF there was a blizzard and a few feet of snow, well that is different sort of story.

The weather this morning is not good so I'm not going into town until it settles down. There is supposed to be an icy mix of 'stuff' moving through.

I spent the day at the hospital with my MIL again yesterday.
I discovered that I actually do have a heart in my body. I've been accused of being too unemotional in the past and I admit it. I usually don't let emotions get in the way of pragmatic thinking.
I put 'the job' in front of me first and don't get all emotional and upset as that doesn't help the thought process.
But yesterday I sat and watched the nurses and lab lady pull blood as MIL cried out and kept crying. I wondered exactly how on earth was modern medicine helping?

Congestive Heart Failure along with Kidney Disease progresses to organ malfunction, fluids in the lungs, and a rather long list of probable outcomes. Death is the last outcome and it is unavoidable.

MIL struggled hard for air and she literally sounded as if she were gurgling.

Two members of the family had been asking if they should come. One is further away and would require a flight.
They didn't ask me though as my reply would have been 'I am at a loss as to why you haven't already come before?'

So I struggled with being the only relative there and I was the daughter in law.

I fetched a warmed blanket after the gals had gone, a CNA said she could put it on MIL.
I said, "No! I'll do it. This way she can feel me tuck her in and put my arms around her. I'm family, it is much nicer to have a family member tuck you in than a stranger."
The CNA smiled and handed me the blanket.

And as I tucked my MIL in and she groaned with delight, I felt my heart fall to pieces.

I was grateful that there was no one else in the room to see my tears or feel my heartache. Me, the ever stoic person.

And I felt anger at the daughter who had said that she didn't want to see her mom until after she had passed because it was too stressful for her.
I thought of the opportunities that the family members had passed up in the last 8 months of seeing MIL happy, clean, well fed, and chipper at the nursing home. I thought of the funny things that MIL and I have been sharing. And I was very angry and then very sad.
And then I felt grateful that I had taken the time to be with her. That I had visited.

And then I thought how much I would miss her too.

I sat back to watch her fall into a much more comfortable sleep.

And before I left for the day I wondered this awful thing.
How we as a human race will let our pets pass on when they are so ill and in so much pain.
But we won't/can't let our chronically ill people go ...or just keep looking for treatments to prolong suffering?

I'm really not a cruel person. I just can't see going through momentous efforts that cause pain and only have the same result in the end.

I am so very glad that Rich and I put together Advanced Directives and Living Wills in place. I know my son will make sure that they are carried out if I am not able to implement them.

Slippage

Brain Disease.
Doctors call it Alzheimers or Dementia.
It is a brain disease.

The brain is a functional organ that is the hard drive for our bodies.
When the brain misfires it begins to have Bad Sectors and cannot be rebooted or reset. Portions of memory files are misplaced or become corrupt and lost in in the recycle bin to be lost forever. The brain slips a bit like a vinyl record with a bad scratch. It is not fixable. Files keep slipping away and taking memories with them.
The brain eventually forgets how to tell the rest of the body how to function.  The 'hard drive' begins to have terrible issues as time moves on, more functions are lost.

Well at least this is how I have come to understand Dementia. I decided that since I have to live with that ugly word, I would make it less ugly and call it Brain Slippage.
I've had to explain my MIL's condition more than once to a relative. The best thing I could come up with has been the analogy to the computer's hard drive and system of files.

Once the computer's hard drive is so full of gaps and holes, the rest of the functions no longer work.

I just finished reading The Last Ocean, A Journey Through Memory and Forgetting by Nicci Gerrard.

If you have an aging partner or parent, it is a worthy read. We can never truly understand how memories and the brain function, but the author show us how compassion and caring are so important. How we should not let those with Slippage become unseen and forgotten people.

Are we truly made up of our memories? What happens when those memories are no longer? Are we then something or someone else? What defines us?

These are questions the author asks us.

When I visit with my MIL. I see slippage. What was reality a year ago or even just months ago is no longer. She has lost 10 years of memories which is fine because she is perfectly happy recalling her house on the ridge and not the apartment she moved into.
Will she recall her great grandchildren? Probably as they are something that may be more important in her file system.
She knows me and sometimes I am younger in her mind and sometimes I am in the present.

Does it matter to her? No, she is perfectly happy or so she thinks. She asked me to show her a photo of the building she used to live in. She said someone told her she used to live there. I brought it up on my phone and showed it to her.
She shook her head.

Nope. She couldn't picture it at all. Couldn't recall what the apartment looked like either.
But the house on the ridge, do you recall that?

Oh yes!
I asked if it bothered her at all not recalling the apartment. And she looked me straight in the eye and asked me:

Why would it?

Indeed.
Don't try to convince her that she HAS to remember. That is such a big mistake with those that have slippage. Don't force what they cannot recall.

Trying to make her recall things that have drifted away is only an irritant. It does nothing to make her day happier.
Bingo makes her happy.
Painting class makes her happy.
Meals make her happy.

Visits from loved ones make her whole world. It brightens the day by day routine of eat, sleep, nap, get wheeled somewhere, and look out a window or stare at a wall.

I don't mind it when she falls asleep while I am visiting. I sometimes hold her hand just to be with her. Sometimes I wait for a while and then give her a hug and leave.
She loves hugs.

One day her memory of me may slip into the recycle bin and be lost.

Morris is Aging

Morris delights in snow, especially the light fluffy stuff.

Actually he loves taking hikes with me at any time he can.

However the older he gets the more I have to be careful about the kind of walks we take.

If the temperatures are near zero and the wind chill factor is below zero, I don't take him.

As much as I don't want to admit it, Morris is aging.  

By age 10 most Jacks Russells should be considered Seniors.  Morris will be 11 yrs old in July.  So he is a 'Senior'.

I see the gray face and I see him slowing down, but mention a hike...or grab the camera bag and he is jumping and going ... crazy, whining and spinning like a furry little top.

It sort of seems unfair that our dogs age so much faster than we do.  Look at that brown muzzle!

This shot was taken in January of 2012.

Oh the difference this year!

He is still quite playful and energetic.  He will toss his toys around the living room for a while and then go snuggle in his blanket on the couch or lay by the heater.

He is now content to lay next to me on the couch and be quiet while I read.

However, if he goes on a long hike in the cold [he runs and jumps and smells things as though he did as a youngster] he will stop every once in a while and asked to be carried.

I want to deny his aging.  I really do.  For nearly 11 years he has accompanied me on nearly every trip to the woods.

But we take one day at a time and enjoy every moment together.

And his loyalty to the grand children is endless.  Who could ask for a better little dog.
The books on Jack Russells say they are not good with children.
Harrumph.
Well Morris is.  He prefers children to adults I think.

He is rather content on these cold winter days to toss some toys and then go lay in a sun spot and enjoy himself.

Some Senior Jack Russels may get a bit cranky in their Senior Years due to those very same things that all elderly folks suffer from. Sore joints, stiffness, and so forth.

So far Morris has not been cranky.  Well unless you awaken him by sitting on a pile of blankets on the couch and find that you just sat on your Jack.

But I do notice now, if it is very cold and the creek is wide, he will put a paw on my leg and ask for a lift over the creek.

We had a great time on our last winter walk a few days ago.

When we got home he curled up on the couch and went right to some serious napping.

I know in my heart that eventually he will become a bit frail and too old to do the things we do together now.

But we are going to go ahead and live life as there is no tomorrow and enjoy each day together.

That is what this ~~ now old dog ~~ is teaching me.

You ROCK Morris!