ER ER off the the ER...

 Okay that sounds rather blasé and flippant but it wasn't. The local ER and I are friends. I've transported hubby numerous times over the years to them. 

The amusing accidents were rather well, amusing. 

Sir, what brings you in today?

I was practicing my ballet in the pasture and tripped over an electric fence. I think I broke an ankle.

Sir, what brings you in today?

Oh playing man from Smokey River with my Stepson racing down a steep hillside. I ran into a tree on my young mule. Then a bull chased me up a tree. [broken ribs and ankle]

Sir what brings you here today?

Well I got bucked off a horse and he tap danced on my head with his hooves before running off.

Those were the accidents when he was that wild guy who could ride anything and did. Those were true stories one I still recall vividly. Tying a maxi pad to his head wound with a kerchief was one of his most embarrassing moments as a cowboy. But it kept the blood from getting all over the car.

Well, yikes. I was going to head off on a whole big tangent regarding healthcare, but I will not. Let's just skip that.

My little cold gave my husband a Severe COPD Exacerbation. We are home, he is miserable, and our house is quiet.

I'm being the nurse, bringing him meds, nebs, and providing support care [I coulda been a nurse!] 'round the clock.

I guess I'll have plenty of time to undecorate the tree --- I don't want to. Or watch movies I like.

However, the best gift I have is still being able to talk and be with my sweet old Grumpy Gus.

He makes Grumpy Old Men seem mild when he is sick.

He'll thank me later when he feels better.

Silence ~ But I can do better!

I live with a person who has several health issues and dementia. Some days are quiet and pretty darned boring. Those are really the better days. Then there are the days that something gets his ire up and well it can get rather tense.

The other day I was watering the large heated stock tank. The outdoor hydrant is above the house on a hillside. I use about 200 feet of construction strength black hose to run water to the stock tank which is plugged in on the porch of the house. I separate the hoses and drain them in the winter. Gravity is such a great helper. Once in the past 5 years I've had one hose ice up on me. 

I separate the hoses by the LP tank. You can see how the slope works in my favor.

The tank fills with very little work most of the time. The two mules that need special feeding requirements are kept separate from the younger mules. Fred the pony mule is 35. Mica is the grey mule. She is has heaves when it is dry and dusty and is a hard keeper. Mica is also blind in one eye. I still ride Mica and put kids on her even though she is our tallest mule. She has a very kind disposition and is very gentle.

So I finished watering, picked feet, and gave everyone except Fred a nice hug and some ear rubs. Fred is anti social and doesn't like being caught.

I wrapped things up and headed to the house. Rich had been watching from the porch door. When I got inside he proceeded to give me a very stern lecture on 'how to drain the hoses properly'. I had the angle wrong somehow and I left footprints and divots in the snow which made the hose freeze up.

He even showed me how to hold the hose properly along with how to walk. It went on and on and on. 

I internally rolled my eyes and then in a moment of stupidity blurted out. "I've been doing this for over 5 years and I've only frozen up the hose one other time during the other Polar Vortex a couple of years ago. It will be 40 today. The hoses will be just fine."

His retort was quick and sudden and a bit nasty. He turned and crossed his arms in a huff.

I realized instantly that I his time frames were confused. In his mind he'd just helped me with it not too long ago. 

He was also stressed out because the program he'd been binge watching had ended. And he was frustrated because somewhere in his mind that he was no longer out there doing simple things like draining the hose.

His punishment was the Silent Treatment. He tossed the remote and and sat on the couch. He stared at the wall arms crossed and breathing in big sighs. After about a half hour, he got up and went to take a nap.

I understand mental health issues a bit. I am a lay person who lives with it. I married a person with it. I don't have any regrets. But there are days when even I can't deal with it and I take my Angel Hat and toss it aside.

However, I grew up in a household where Mom was the Expert at Silent Treatment. She could've taught a Master's Class in Silence and exasperated looks.
I knew I shouldn't engage in it, but I did.

I plugged my earphones into my smarty phone and dialed in Pandora. Mom was the expert and I learned from her. My Mom had some mental health issues too, so I'd learned from the expert. My poor dad, I don't think he ever could understand Mom.

Silence feels like a superpower. It is a very powerful weapon. Sooner or later hubby would need help with the TV or he would want supper. I rolled these things over in my mind and decided that I'd break his silence as soon as he got up from his nap.
After all, I should be the better person in this as I am caring for him.

There is no arguing with Dementia. I discovered that with his mom. Let them rant, let them tell you what is what and simply move on. Hard to do when you literally live in close proximity.

After his nap, he wasn't having anything to do with breaking Silence. He stood with the remote and kept clicking through programs and sighing loudly. I let him.

I started to bake chocolate chip cookies. Our cottage/house is very tiny. Pretty quick, he entered the kitchen and stood.

"Whatchya doing?"

Me: Baking cookies.

Him: Didjya fall on your head? [His joke at any attempt by me at baking.]

Me: Must have.

Him: Let me have some.

Me: Okay. Can I help you find a program?

Him: Yes please.

The Silent Treatment broken and things back on an even keel.

Waiting

 

I'm not good at sitting and waiting. And then wondering and waiting.

This morning Rich told me his oatmeal was bad, it didn't taste right. I poured him some of my strong coffee and he sipped it. I asked how it was. He said it didn't taste right either.

Normally if I don't add water to the pot and make the coffee much weaker, he has a fit. He ate and drank his coffee, took his meds, and I approached him about seeing a doctor. 

I told him that his returning fever and the lack of taste and possibly smell [he said he was congested and couldn't smell anyway], along with body aches, extreme fatigue and struggles with 02 were pretty damning for the dreaded Covid. Or at least a reason to be tested. Perhaps it was just URI and a doctor could make things more comfortable for him.

He said he didn't want to go stay in a hospital. He knows what that scenario is like. He'd be alone without anyone. I agreed. So I called the VA Triage Line and am now waiting on a Triage Nurse to call back. The VA has a protocol for things like this. If it isn't an ambulance call or severe enough, they will fight the local ER regarding treatment. I've been through this for 24 years. They will want me to transport him 89 miles one way. I will plead my case for a 10 mile drive.

I will never forget what he said next. 
'So I should die at home.' 
I replied, 'Let's not jump the gun.'

'So where did I get it? You? Charlie? Did you let people pet Charlie that day you took a walk? They gave it to him, he gave it to me.'

After putting him back to bed and hooking up the CPAP, I sat down and did my 'contact' tracing.

The only persons I had contact were with
Two humans who briefly touched Charlie, 12-4
the checkout person at the store on 12-8
the FedEx guy who handed me a package and we briefly talked because it was dark and I had to show him where to turn around, 12-10 
distance hiking outdoors with Bill, 12-11....

Can you imagine the guilt I and the amount of anxiety I am suddenly inundated with? How did he even get sick if it is just a respiratory infection? What did I do wrong?

What if?

What...

if...

I do live with a man who is health compromised in the first place. Last year we wouldn't have questioned it much. We would have assumed it was a bad cold and respiratory infection. He has not been sick [nor have I] in years. 

I dropped him off at the local ER. Here is the difficult part. No spouse admittance, I could 'go do errands and shopping' or go home. The nurse was nice about it as she unloaded Rich in the ambulance bay. I wanted to point out to her how ridiculous 'go shopping' sounded in this day and age. She was just being kind and saying what was a common saying a year or so ago.

I told her I'd wait for a first impression and report by telephone in the parking lot. I did.

A Covid test will be done, chest x-rays, blood tests, the usual poking and prodding. I could expect an update in about 3 hours.

So now I am home doing laundry carrying my cell phone as if it is a life line.

Waiting...

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Update....Phone call from the nurse.
We will be admitting your husband here. There are no beds available at the VA.

Let's parse that out. No beds.

Me: What is the diagnosis?
Nurse: 99% positive Covid-19. We have given him....

I listened to what their plan of action for the moment was.

Me: Then I should be quarantined. Should I be tested?
Nurse: Quarantined yes. Tested no. You have not shown any signs correct?

Nurse: We will update you when he is put in a room and when we get the final labs back.
Me, quietly: Okay.

Hangs up phone.

Primal Screaming really scares Charlie. Maybe I should do it outside.

Abulia

That is not a word you will hear often. In fact, until today, I've never even heard of that word.

I found it while looking through some articles on Stroke and Apathy. I was looking things up and I do not really believe in 'looking' or Googling symptoms for information, I do know that reading scholarly articles or NIH articles are helpful.
Sometimes while I am waiting for Rich to get up if I am not at CrossFit, I will do some 'heavy' reading on Strokes, COPD, Mental Health, and other issues that seem front and center in our lives.

While looking up Apathy in Stroke survivors, I stumbled on another word. Abulia.
Now we have been seeing Rich's psychiatric doctor nearly every two weeks. Dr S. really was amazing in helping Rich get out of his last horrible MDD, Major Depression.
However, I think depression is not the only thing affecting him at all. Last year he had an extensive Neurological exam done with two Neurologist and Behavior Specialists.

Here is where Neurology meets Psychology. They actually blend in this case as Rich suffers MDD [Major Depressive Disorder] which was helped earlier this year and we had a much better summer thanks to Dr. S. But blend in all the medial issues along with the Brain Damage and the ongoing progression of Brain Damage and what do we have? Apathy? MDD? PTSD? Brain Slippage?

We still can discuss certain subjects that are near and dear to him. But the year of endless TV watching has now stopped. And I mean stopped cold. In its place is a man who sits at the kitchen table and stares out the window or stares at the kitchen table for very long periods of time without speaking or moving.

I do engage him in as much conversation as possible. I tell him about my workouts, the people I see at CrossFit, and sometimes read him news stories. He listens and responds but mostly he is silent.
Am I not pulling him outside and forcing him [rather unwillingly] to functions? He said his Pulmonary Therapy was okay. But now he can't do it. Can't.

Some days I feel like someone dumped me in a deep pool of water and the harder I swim to get out of the pool ... the further away those pool edges move.
Yesterday I went out after CrossFit to a coffee shop with a pal from CrossFit. We sat and just chatted. She chatted a lot. Her parents are elderly and I think she had a few things that she needed to get off her chest. I have learned to sit and be quiet and not turn around and complain about my issues when someone needs to unload.

I found our hour sitting there watching people walk by on the street and sipping coffee to be extremely relaxing. I dreaded going home to the silent man who would either be in bed or sitting and staring off into nothing.

I feel if I could just push him somehow, I could make him better. But in reality, I can't.

So what is going on? Med changes don't work. Ever since his stroke, Rich reacts violently to most medications. His latest new med for depression was interesting and frightening. He had some rather nasty reactions.

Winter is his worst time of the year anyway. I hate the thought of going through months of MDD again. It is like living in a life sucking hole of blackness.

That is why I work out. That is why I hike. I need to preserve sense of self.

But what of him? What is Abulia?

Apathy, Disinterest, Passivity, Lack of Opinion, Asocial, Extremely quiet or mute, Emotionally remote, Indecisive, ...the list goes on.
Depression meds do not work with Abulia.

It is a neurological/brain issue. I don't know, but I am grasping at straws because, if YOU can name something maybe you can work with it?

Anyway, I messaged Dr. S to ask him about this. Maybe just treating these issues as depression issues isn't the answer. Maybe we are all barking up the wrong tree.
Maybe
just
maybe
there is no good answer because who the heck knows what really is going on in a brain that has damage?

Will I get used to this changing person who sits mutely at the table?
Can I adjust to him sleeping all day and awake most of the night? He sits in the dark and ... well I have no idea what is going on.

We meet with a Neurosurgeon on Thursday to see what the latest MRI of his brain shows.

I'm tired today. But I have so much yet to do.

This should have gone under the blog The Long Road, but I'm putting it here, as this is part of my daily routine as a CareGiver.

Hope Glimmers

Sometimes things look slightly better with a glimmer of hope.

You know dreary days can be SO darned dreary! We've had endless bouts of gloomy and rainy cold days mixed with wonderful warm days. Those days involve me trying to mow the areas I can without floating the lawn mower.

So that leaves out the hills as the ground under the grass is so saturated I'd leave brown tracks. Hmmm. I may have to wait on the lane for the land to dry out. By that time the grass should be at least knee high.
But wait!

I know Sven can't keep up with it, and Lil' Richard is doing his best around the old tractor and vehicles...
So I may wait until the lane is nice and dry and let the mules in to clean it up all at once. Then I just need to spread the manure they leave behind.

Problem solved!
I may have to do that to the hill in front of the shed too. That will be a bit more difficult to organize, but since I am so good at temporary fencing, I just may do it.

May is proving to be interesting. I've really had good luck on the warm afternoons hunting morel mushrooms. I will probably go out this afternoon with my electric fence roll and string one line and then since I will be at the creek...I will do a quick hunt before walking back up to the house.

I know where there were some very tiny morels on Saturday, so I'd like to go back and see if they grew.
So far I've had plenty to eat and I've dried a lot for soups and stews this winter.

Rich's depression has lifted quite a bit with the help of Dr. S.
Wow.
We saw Dr. S yesterday and he said the difference was night and day. The Gnarly Witty and sometimes bizarre husband of mine was bantering with his psych doctor.
Rich's Pulmonary Function Test was no surprise.
Severe COPD.
Now we didn't get the official numbers but as Jim the Pulmonary Therapist who evaluated him last week said, some Pulmonary Therapy and better Oxygen delivery would make him physically feel better.

Community Care from the VA just called to make arrangements locally for PT for Rich. We know that Rich will never get rid of his oxygen tether and that for traveling he will need a constant flow rather than the pulse flow he has now. At home he is on a constant flow.
The 02 metering may have to go up too, but...they want to see if PT helps first.

The biggest hurdle will be getting some strength back.

But never mind that. The thought of Pulmonary Therapy gave Rich a glimmer of hope and a small sparkle in his eye. I knew it.
I knew that without lifting some depression that nothing would make him see hope.
We all know the end game of life. But if there is a small chance of still enjoying moments...it is worth the trip.

What to live for

Yesterday was a busy day. We'd gone to the VA for appointments on Tuesday and it felt like we spent the whole day going from one place to another.
Actually we got in early and were seen early which is not the usual way things happen.

We have the Kenosha Gang coming this weekend. They aren't actually from Kenosha but I met them while living in that county.
So I was anxious to get the yard work started and at least do some picking up and preparing for their visit.
Rich's meds in the morning make him light headed and dizzy. Two inhalers plus a nebulizer treatment in the morning seems to make him wobbly. He feels constantly stuffed up and we asked the ENT folks Tuesday to check that out. They are following up on the Throat Cancer, fingers crossed...all looks good.

It seems one of the meds for prostrate enlargement is making his sinuses a bit swollen. It is a side effect. IF anyone can have an unusual side effect from medication, it will be my husband.

I looked up his meds and yes, they keep him going but sometimes I wonder if the meds are doing as much harm combined as they could be doing good? I think a major review of the medications are in order. So many of his meds have dizziness as a side effect.

The good news from the CT scan with contrast is that the aneurysm in his brain has not shown any change, nor are there any signs of new strokes.
The bad.
He feels lousy, he has no ambition or energy, he feels dizzy and out of breath often, he has tremors, and emotionally flat most of the time.
The grumpy Gus I used to be married to no longer oversees my fencing or corrects the way I do projects. He shrugs and watches Netflix or takes a nap.

Yesterday morning he sat with his coffee after eating breakfast and said, "I'm just slowly dying, fading away. I wish I could feel like doing something or just trying to do something."
I said nothing. What could I say? He was right. My husband was fading before my eyes.
The man who used to be the Take Charge Man, no longer shows interest in most things.

Hopefully our meeting next week with Neuro-Psychology will prove helpful. In a way Rich felt as if it would have been kinder if the doctors had not been able to remove the two clots in his brain and had just let him go.

So he went to bed for his morning nap and I told him that I was going to go outside and work. That is what I do when I am frustrated and feel helpless.

I started up the weed eater and attacked the long grasses next to the shed. Then I went after other messy places, those places that are so hard to mow.
After my hands began to hurt, I put the ''eater' down and started to trim with the little mower. I took breaks often, but got all the trimming done around the house.

After lunch Rich came out and mowed a portion of the yard and then went to lay down again. He said he'd finish the rest of the yard after a rest.

I proceeded to work on the new/old chair after I watered and rotated the Dexter cattle to a different section of the woods. I sat on the porch and took out my paints. I'd worked out my frustrations and now it was time to let my creative juices flow.

Remember that ugly chair?

Well I have been working on it a bit at a time.

I usually don't plan things out and just let it happen. I wanted bright cheery colors so I used brilliant yellow spray paint on the legs and added some aqua. I used silver on the back of the chair. I don't know why but just did.

I had some old white paint that needed to be used up so I painted the seat white. Boring old white.
While I was at it, I spruced up the wooden spool that we use as a porch table.

I finally got around to doing the edges....not shown here.

The plain white boring seat bothered me, so I did some touching up here and there and then started to experiment with some masking tape.

That was fun, so I began mixing the aqua, blue, green, and seafoam colors in a cap and creating my own colors and made more stripes.

Okay. Nice looking but not FUN!

The stripes aren't perfect, and the paints aren't perfect, but it had its charm. However it needed something else.

Now I am completely charmed by this old chair. If it lasts a season or two on the porch I will be happy. My butterfly happy colored chair.
It fits in so nicely with my spool table and funky table top...

Ready for company!

Charlie was exhausted.

All that supervising wore him out.

The day was still 'young' after supper was cleaned up.
Remember I said I had the Kenosha Gang visiting this weekend? They want to go riding. So I am saving some time and saddling each mule we will take with the saddle that will be used on them with each rider. Amanda will ride Sunsine in my Western saddle that I modified. So last night I saddled Sunshine and took her for a rather boring but peaceful ride on the gravel roads and hay fields.

Sunshine is out of my original horse, Cheyanne. She is half sister to my all time favorite mule Badger who is no longer with us.

And...
then...
my day
was complete...

Well in this life you must find something to live for
Cause when darkness comes a callin'
You'll go back to where you were before
Cause this life is as
Fragile as a dream, and
Nothing's ever really
As it seems...
~~Lily Kershaw
"As it seems"

This and That

What a welcome surprise. Nice unusual weather.
Dry and warm.
The National Weather Service has issued advisories however that this warm dry spell has increased our fire danger.

However we are taking full advantage of it.

Last minute fence repairs before mother nature blasts us with subzero temperatures and snow.

Moving the round bale feeders.
I do love a guy who can operate a skid steer!

Morris supervised from the porch. He had been sleeping on the blanket I gave him but decided to start barking at everything. I brought out his crate and he went in it.
His imagined monsters can't get him in the crate.
He settled down and napped when he wasn't watching.

Rich and I pulled fencing from the Merry Meadow. The work to maintain the fencing is now too large of a job. Mowing the meadow wasn't done this year and since it isn't our land I'm willing to just let it grow wild again.
It served a good purpose for years, however the more things stay...the same, the more they change.

We met with Rich's speech therapist again yesterday. She gave us some insights to the 'new' Normal. I do not like that phrase Your New Normal, but it is appropriate.
COPD affects so many things. She enlightened us to the fact that the brain uses 20% of the oxygen in the body. When short of breath from exertion, the brain is getting shorted also. An already damaged brain from a stroke is fighting harder to get its oxygen.
Confusion and memory issues immediately arise.
If left short of that wonderful 02, more brain damage can result.

It helps me understand what is happening to Rich when he is trying so hard to do chores. He is not a quitter. But it helps me understand why he feels lost when he is out of breath.
COPD is an insidious disease that forgives no one. You cannot escape it and as it slowly eats away at your health.

Our new thoughts to take home from Speech Therapy are these two things:
I am Rich, I am "As Is."
The more things stay the same, the more they change.
[Yes that is the exact opposite of the saying, but this fits better in our case.]

So.
It seems that some or most of the work will fall into my hands for getting everything ready for winter.
I'm up to most of the task.

The Dexters we are keeping will move into the paddock just south of the house where they can share a 300 gallon heated stock tank of water with the equine who will be in their winter pasture also.
One heated tank. One hose to fill it. The chores will become much more manageable through the cold.

Mr. Morris seems to be doing fair. Yesterday the neighbor and her son came to let him out for a potty break and drink of water. Morris apparently didn't 'see' the porch post until he ran into it. He has done this off and on lately. I don't know if he really has doggy dementia or what. I do know that his hearing is negligible and that his eyesight seems at times to be a bit questionable.

However, all of this and that aside, we are having an incredible end to November.
The skies have delighted us with morning and evening surprises of brilliant colors.

And thus, another month ends.
Tomorrow is December.