Sunday, October 30, 2011

Where Has Another Month Gone?

I knew it had been a long time since my last post, but almost a month... really? That should tell you something about how things have been going. It has at least seemed like an unusually busy month, and certainly there has been no time to get bored! But isn't that the life of all of us who are members of this Sandwich Generation?!

My sister finished her CNA classes and began a job at a local nursing home, working the 6:00 a.m. to 2:00 p.m. shift. Thankfully (and to my amazement!), the daycare that Timothy attends opens at 5:15 a.m. I asked his teacher, "Do you really have children come that early?" She nodded her head and said, "Oh, yes!" So Timothy arrives at 5:30 a.m., and my sister picks him up in the afternoons, sometime after her shift is over. So far, he is doing well... he certainly enjoys that late morning nap for 2 hours or more! But he is thriving at the daycare and really loving his teachers and his new friends.

When I last posted, my grandmother had just had her monthly visit from the facility physician. She had given him the same complaint she has given me for years, "I can't pee." If you have followed this blog for a while, you know that we even made a visit to her previous family physician for this once, and he tried to explain that she takes Lasix and does not need to go on the hour, every hour, all day long. But still, she continues to complain. So in an effort to appease her, the new doctor ordered an "in and out cath" to see how much urine she retains after going to the bathroom... and to show her that she is really emptying her bladder.

When I arrived for a visit, she said, "The doctor has been here, and he told that nurse they would do surgery." I questioned her... "Surgery? On what?" "Well, on my kidneys... I can't pee." That's when I found the doctor in the facility making rounds, and he assured me it was not surgery - just this "in and out" procedure.

The catheterization showed little urine in the bladder. But in the words of the LPN who administered the procedure, "It looked nasty." A culture was ordered, and we were told that there would probably be medication forthcoming... but not until Monday.

Meanwhile, Mam-ma began to complain of burning and being uncomfortable. The nurses kept telling me, "The doctor cannot prescribe any medication until the cultures are conclusive as to which bacteria is involved... and that will take 3 days." It took roughly four, since the pharmacy that serves the facility did not deliver any medication until late Monday night, and somehow there were no orders from the nurse (or any that were seen by an aide) for the medications to be administered. I now have a box of AZO tucked away in Mam-ma's bathroom that the LPNs or I can administer for the burning, if she has problems again.

In retrospect, this is what has been dragging my grandmother down for weeks. She had a UTI in late July/early August and was on antibiotics. When she became dizzy and disoriented in late August and we transported her to the ER, the attending physician's first idea was, "She has residual infection." But the labs came back clear. Now we realize that this test was probably a "dip stick" in a cup of urine... and without a culture, the underlying infection was not discovered.

At any rate, injections of a very strong antibiotic were ordered for 7 days, accompanied by 7 days of oral antibiotics and something for burning. And... over the weekend, the nurse telephoned and said, "We think Polly has pink eye. Her eye is red and swollen this morning. It's either that or allergies... or she slept on it wrong. We're ordering an antibiotic for that, too!" For seven days, Mam-ma took THREE antibiotics. Now she says she feels better from the UTI, but she is still trying to recover from taking so much medicine.

During all of this, we continued to keep Timothy a day or two here and there. One Saturday morning, I took him to his first birthday party... for a fellow daycare attendee who was turning three. This was a "prince and princess party" - about four little girls in princess attire, and two little boys. Timmy did not go in costume. The party was held at a local playground, and the parents had added a "bouncy castle" and a pinata, as well as a craft project, a cake that looked like something from the Food Channel programming, and party favors that went on for days. The bar is set high for future parties!

My 2 favorite boys... Timothy's
first football game!
Timmy had a ball, but he came home exhausted and really cranky and ready for a long nap. We've also taken him to a couple of local high school/junior high football games lately, and he has loved that... especially the band. It seems that we're learning to take him along wherever we go and continue with our plans as much as possible... knowing full well we may be leaving early. One night we didn't make it to halftime... Timmy fell asleep in my lap during the 2nd quarter!

With the routine of daycare and my sister's job in place, we were actually able to take a few days to help with a conference that was held in our community by the company we developed and sold six years ago. We still stay in touch with the new owners and try to keep up to speed on what is happening with our "baby," and this gave us a chance to renew some relationships and see firsthand how the business is doing today. But it was a hectic, tiring string of days/nights, and then it was back to our "routine" with our own family and household.

After several days of bouncing back and forth between caring for Timmy and seeing about Mam-ma and the conference, I had a chance this week to finally work on our house and get it cleaned and back in some semblance of order. I realized that it had been several weeks since I had actually done laundry for us, so that in itself took a full day or more. When you are washing towels and baby clothes and pajamas every day or so, it is easy to lose track - until you don't have any clean underwear!

We kept Timmy for a couple of days last weekend while my sister worked, and all day Saturday, he was fine. Saturday night we were watching videos on the computer when he suddenly erupted... vomiting everything he had eaten for three days, it seemed. Greg helped me get him stripped and to the bath tub, then watched him while I changed MY clothes and cleaned up the mess. Yes, if you are following this posts, this is twice this month that we have had these events.  This little boy has had a rough few weeks!

After that, Timmy seemed subdued, but okay... until the next morning, when he was sick again. I watched him closely all day and monitored his food and drink, but by Monday morning, he was better and fever free, so I took him to daycare. He did pretty well all day, but that evening, my sister said he threw up all over HER... her first foray into this side of our precious charge! Bless his heart... he is so pitiful when he's sick... and it scares him - he does NOT understand what is happening. My sister had Tuesday off, so she kept Timmy at home and made sure he was feeling better.

I managed to get our house cleaned, laundry washed and ironed, and everything in place before the weekend. Greg had cousins visiting from out of state, and we were planning to spend time at with his family. I made a visit to the ALF to make sure Mam-ma was okay. I picked Timothy up on Friday afternoon at the daycare and brought him to spend the night with us. Greg's family came to our house for a visit and take-out pizza, which made it much easier with the baby. Yesterday we went for a brief visit at Greg's brothers... Timmy in tow... before my sister picked him up when she was finished working.

Today my mother has taken my grandmother for an afternoon drive to see the fall color, which will help her spirits tremendously. Tomorrow, Timmy will Trick-or-Treat at her apartment (I left candy there for her to give him), and next weekend, we will take her to lunch to celebrate her 99th birthday on Saturday. I am hoping that the days in between will be uneventful. The doctor will return for a monthly visit on Friday, and I anticipate that he will declare her to be greatly improved... if not completely well.

I feel like for the moment we are settled into something of a routine... helping with Timothy as needed while my sister works... checking on Mam-ma several times a week... and trying to have a life in between. My husband is so good to go and visit my grandmother, refill her bird feeder, and spend a few minutes with her - just the two of them. She loves that. I already know of at least two people who are planning to visit her from out of town on her birthday, and that will be huge, also. For now, we're trying to make the most of every day... savor the special moments with our little nephew AND my aging grandmother. So far, so good! Yeah, what am I saying?!

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On another note, I still have some checking to do, but it looks like I will not have to change Medicare Part D Prescription Drug Insurance providers for the first year since the program was implemented! Thank you, LORD!!! I think I have had five providers, so far...and that doesn't count the one that Medicare so nicely switched me to on their own the first year! (I got it switched back, since their plan covered virtually NONE of Mam-ma's drugs!) I am glad that at least once, it looks like I won't have to go through all of the shenanigans that are involved to transfer to yet another provider. I will make a call to the pharmacy to doublecheck this tomorrow, but it is looking pretty good at this point! Yippee! See how little it takes to make us Sandwich Generation "fillings" happy?!

AND... a cousin recently suggested to me that I needed to have a DNR order handy for my grandmother, so that no heroic measures will be taken to keep her alive, should something happen. These are her wishes, and I mistakenly assumed that the Living Will covered this. It does not! So... we now have a DNR (Do Not Resuscitate) order on file at the ALF, along with a copy of her Living Will. With both of these in place, no life-sustaining measures should be enacted, were she to have a stroke or heart attack, etc. If you do not have these documents for your aging loved ones, I encourage you to get them. You can download the forms online, or talk to your attorney and ask him/her to supply them.

I talked with Mam-ma about the DNR paper to be sure these were her wishes. She insisted they were, saying she did not want to be a vegetable. "And besides," she added... "the sooner I'm off your hands, the better!" I told her emphatically that she is NOT "on my hands," but I had assumed she was after a "one-way ticket." She said, "Well, I AM!" Gotta love my grandmother!

I hope things are well in your "Sandwich" this week!

Thursday, October 6, 2011

Preparing for Anything...

Today is a "rest day" for me... much needed after the past week.  Timothy stayed with us the first part of last week, and then for a few hours in the afternoons on Wednesday, Thursday, and Friday, until his GaGa finished with her CNA classes.  Friday, I visited with Mam-ma and did things at home that I had neglected.  Saturday, I learned that my cousin's aunt... the one who just turned 90 and missed her birthday because she had to be hospitalized with a UTI... had passed away.  I factored a visit with my cousins into my afternoon, along with a shopping trip for our own groceries... and shopping for my 85-year-old mother-in-law, who is having knee problems.  My husband had asked her to please stay off her feet - and on her couch... and we offered to bring her some prepared meals and a few other groceries she needed.

By the time I finished all of my "rounds," I was too tired to cook dinner, so Pizza Hut was a welcome reprieve.  Two carry-out pizzas and some R and R on the couch, and I was feeling much better.  However, Sunday I "worshipped at St. Mattress," as my friend Mitch so aptly described it recently, and I caught up on some much-needed sleep and rest. I did a few loads of laundry, ran the vacuum, and did a workout.  Then I picked up Timothy around 4:00 p.m. at his grandmother's (my sister's).

Timmy swimming at the Community
Center pool with his great Granny (my mom).
Timmy was wearing a "fever patch" on his forehead, and my sister said he had been feverish and had a runny nose all day.  I brought him home, gave him Tylenol and some children's Zyrtec, and let him soak in a bubble bath.  He seemed better after that, and we played until bedtime.  He slept somewhat fitfully... but he did sleep.  The next morning he was fever free, so I took him to daycare, so that my husband and I could attend the funeral of my cousin's aunt in the afternoon.

Following the funeral, we returned to my cousin's house to visit with the family members we rarely see.  My little cousins, Owen and Olivia were there, and their mother said, "Oh, I wish you had brought Timmy."  So I went and picked him up at daycare and brought him over to play.  On the way to the house, I told Timmy we were going to play with Owen and Olivia.  He was so excited, and he said, "I hug 'em!"  Then he added, "I kiss 'em, too!" 
Then Timmy said, "DebDeb... I so happy!  Are Oooo happy?"  I smiled and told him yes, I was very happy whenever he is happy.  He said, "I happy, you happy, me happy!  Yea!"  So sweet!  And he truly is a happy child... and he enjoyed playing with Owen and Olivia.

Meanwhile, my mother offered to check on Mam-ma for me... and Sunday afternoon, she took her on a long drive.  We are having gorgeous fall weather, and Mom took Mam-ma "all over the countryside," as Mam-ma put it!  She even took her to Sonic for an ice cream cone.  Mam-ma loved every minute of it, and Mom has promised to do this again.  She said, "I don't know why I didn't think of this earlier."  Mom has been a big help with Mam-ma lately... visiting her when I am tied up with Timothy or other things and calling her more often.

Timmy did not sleep well Monday night... more fitful tossing and turning.  Tuesday, he would not nap, and he ran fever off and on all day.  The daycare did not have a vacancy for him, so we just played at home.  Tuesday night, he was so tired that he went to bed at 8:00, but he was awake with nightmares or something at 8:30 and 10:30, and at 1:30 a.m., he awoke drenched in sweat, soaking wet diaper, and asking for milk.  I changed him, stripped off his clothes (amidst a major, ear-piercing, hysterical fit), and settled him back in his bed.  I thought, "He's settled for the night now!"  NOT!  At 4:00 a.m., he awoke, crawled into our bed, and said, "Milk!  Jack!"  I got more milk, changed him again, and turned on "Jack's Big Music Show."

Timmy has been having diaper leakage again, so I've been limiting his night-time liquids and double-diapering at bedtime.  It has worked fairly well the last 2 weeks.  Wednesday morning, we watched 2+ hours of Jack and "Wonder Pets," and we both drifted off to sleep again shortly before 7:00 and slept until 9:30.  When Timmy woke up, he was feverish again and somewhat clingy.

By 10:30, I thought Timmy was ready for an early nap, and he actually said, "Couch!"  We got on the couch and settled in together.  But he asked for more milk, and when I got up to get some for him, he followed me to the kitchen.  He whimpered and I picked him up and carried him back to the couch, where he promptly threw up... a LOT... all over himself, me, the couch, and rug.  I scooped him up and started across the floor toward the kitchen, and he threw up again. This was the first time Timmy has thrown up since he was about 6 months old.  It really scared him.

I quickly stripped both of us and carried him to a makeshift pallet in the living room floor.  Thank goodness we have hardwoods, because we left a trail you would not believe.  My husband came in and wrapped Timmy in a blanket while I ran around in my underwear and tried to sop up the mess and regroup.  Timmy was burning hot with fever, so I gave him 7-up and Tylenol, and he laid limp on the pallet for about 45 minutes.  Then as quickly as he got sick, he popped up and seemed much better!

The rest of the day we tried to remain quiet and keep the fever at bay; however, I could not get Timmy to nap.  We ditched plans for a haircut and a visit to Mam-ma's... apparently this is a "bug" that is circulating in our town, and I can't risk exposing her and the others at the ALF.  My sister picked Timmy up at 5:30 when she completed her last CNA class- she is official now (YEA!).  She said Timmy was asleep before they arrived at home... and he slept until 8:30 a.m. today!

After the baby left, I stripped beds, did laundry, and regrouped... then headed for the couch!  With a good night of sleep, I am better rested, but still tired.  I realize that younger moms do this every single day... but for me, it's a lot... especially with the other factors and people for whom I feel responsible.  I talked with Mam-ma today and explained why I have not been to see her this week.  I feel like I am neglecting her, but I am confident she is safe and comfortable and well-cared for at the ALF... and she knows why I am not coming very often and seems okay with it.

My house is not nearly as clean as I would like, but I am learning to let things slide a bit in favor of being rested and doing what absolutely HAS to be done... and anticipating "the next big thing."  I'm learning to roll with the punches... that comforting a frightened, sick little toddler beats dusted furniture and a haircut any day of the week... and that hearing "I so happy" from my little guy is possibly the BEST phrase in the whole world.

One other thought... Sandwich Generations are nothing new.  At the funeral of my cousin's Aunt Louise, there was a lot of talk about the service this dear lady gave to her family.  She never married... spent 90 years taking care of others.  When her sister suddenly became a widow with three small children and another on the way, Louise took them all in, and they lived with her and Louise's parents... forever.  Louise retired early to care for her ailing elderly mother, then she helped with the care of her sister, who developed Alzheimer's.

Along the way, Louise taught 3 and 4-year-olds in Sunday School for 25 years, helped with the rearing of her sister's four children - school functions, weddings, births of their children and helping to babysit, family gatherings, and much more. Louise's life was very much serving as the "filling" in a sandwich that included elderly parents and her sister on one side... and the younger generations on the other. And nobody could recall ever hearing her complain.

As we reminisced about Louise and noted how well she had loved and care for so many throughout her life, I realized that she is a tremendous inspiration. If I can make my "sandwich" half as rich as hers, I will have truly accomplished something in this world. I don't know how she kept such a positive attitude, but she has motivated me to work on the grumbling, too. Wish me luck!

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BTW... the formularies for Medicare Part D Prescription Drug Coverage have arrived... it's time to start picking our new plan for 2012! So sharpen your pencils and start calculating!