What's Been Happening

Mom's first medication for her AD (pre-official diagnosis) was 5 mg. of Donepezil (Aricept). After about 2-3 months, her doctor, Dr. N., upped the dose to 10 mg. a day. I believe it was at that visit that he also suggest she visit with the neurologist, Dr. D., and get an MRI on her brain. Sometime between those visits, she was also prescribed Remeron to increase her appetite (as with most people with AD, I've learned, one of the symptoms is loss of interest in eating and food) and it also acts as a mild anti-depressant. She added that pill for the first two nights, but didn't like the way it made her feel so groggy in the morning, so Dad allowed her to stop it for about a week. This was all still before "the official diagnosis", the brain scan results. And all this was only a few weeks ago.

On Friday, October 8, 2010, a few days after the test results were shown and Dad began to believe the inevitable truth, Dad left after lunch to fulfill a commitment he had made to work a political booth at the local fair. Being away for this long a period (over 4 -6 hours) was still something he thought he could do. I live next door, and I've been keeping tabs on their whereabouts for quite some time now. Mom was distressed that Dad would be leaving for so long, and when I stopped by to check in on her about an hour later, she complained that she hurt her back. I assumed it was a muscle pull and gave her an Aleve, propped her up in her favorite chair with a book, and went back home to attend to my chores.

Around 4:30 that afternoon, she called and was stressed that Dad was not home yet (I assured her he was on his way, traffic was bad, he was picking up dinner), she agreed to that, but then admitted her back was really bothering her. I offered to bring my heating pad over, and she was very happy about that. This was a holiday weekend, and my older sister Clarissa came up Saturday afternoon (she lives 2 1/2 - 3 hours away in Mass.) for one night to check in on things. She was pretty shocked at what she saw with Mom. We had a long discussion about it on Sunday afternoon in private, and we both agreed things were getting to a critical stage.

It wasn't until Tuesday morning that Dad was able to call Dr. N., the internal medicine doctor, about Mom's back pain. He also told the assistant that Mom hadn't been taking the appetite/anti-depressant drug, Remeron, but somehow, Dad had convinced her to start it up again, but it had only been a couple of nights. Dr. N. suggested she should come in that day for an X ray.

October 11, 2010

Later that night, Tuesday October 12, the doctors office called with the results. Mom had a compression fracture of the 6th thoracic vertebrate. She was upset and lifting a small tray at the same time, this is how it happened. Because she has lost so much weight and been so inactive for over a year now, she has become very frail. In hindsight, I wish I had been more aggressive with her eating and exercising, however, there is no sense in beating myself up about that now.

Between the alarming reality of this news and the visit with my sister, Dad finally realized it was time to get more proactive and at least gain some extra help. Our neighbor had already suggested a great private home care worker, who lives just down the road, and helped out our other neighbor's life partner in his last year with dementia and AD. Dad was set on calling her, and Mom hadn't had a bath in over two weeks. He had given her a few in the last month, as I had one on the last weekend of September, but now with the back pain and the deep tub, it was time for extra help. He called Maria and she came over for a visit that afternoon (after the X ray visit and before the X ray results phone call.) I met with her, too, and it was agreed that she would come the next morning and give Mom a bath, and at that same time once a week. Maria went to our neighbor's house and got the special bath chair, and I told Dad to go to the local pharmacy and purchase a shower hose.

Maria was great, and in our first visit, also suggested purchasing soy protein powder or Ensure to help boost Mom's caloric intake. She had other suggestions like prunes, broccoli and bananas for potassium. In the last few days, Mom's appetite has seemed to increase, and Dad has been much better about giving her more foods with snacks in between meals. Meanwhile, her back pain is still there, off and on, and a Tylenol every four hours was prescribed for her back pain, as well as movement.

The next Saturday, October 16, my brother Nat came up from Mass. for Saturday night to spend some time with Mom and Dad. He was really great and brought up some food and one of his favorite drinks, soy milk. Every Sunday, Mom and Dad have always gone to church, but, wouldn't you know it, now Mom's coming up on week four of refusing to go anymore. The back pain was the first excuse, but it's also the confusion with singing in the choir and talking with the people, classic symptoms of AD. So, on that Sunday, the second time she missed church, Nat spent most of the morning with her, and even got her up and walking around a bit. Thanks to Nat, she now tears around the dining room table for exercise. It's kind of cute to see.

Later that day, a couple from church, friends who had spent time with Mom before she worsened, came to stay with Mom for the afternoon. Dad was performing in a church concert from 2 - 3 pm, and would not be home until 4 pm. Sadly, he had to do it alone this time. Up until this year, they were always a team in the choir. Because Mom's back pain was still acute, she wanted to stay home, though she hated to miss her husband's performance. The couple from church were very patient and sweet, and just sat and read together while Mom nodded off for a bit. She seems to sleep a lot more now.

So, this pretty much leads me up to yesterday, October 20, where we visited with the neurologist, Dr. D., for a discussion about the results of her brain scan. Right off the bat, the first simple question he asked Mom made it painfully clear she is suffering from this horrible disease. She could not connect her thoughts to her words, she stammered, she got lost, she looked to her husband for help. It was very painful to watch. Finally, after three years of wondering, of assuming that Mom suffers from Alzheimer's Disease, Dr. D. was the first official to come out and say it, directly to her face, that she is experiencing the first stages of Alzheimer's Disease. Finally, somebody said it. Dad said, "this is what I have suspected" and so finally, he said it, too. Mom nodded, she knows.

Dr. D. clearly stated there was no known cure for this disease, but empathetically proclaimed he really wanted to help her. I really believed him. He asked her if she would like to participate in a clinical trial, and when she strongly said "no", he did not push the matter. He could see how uncomfortable Mom was with her back pain, and wrote a letter to Dr. N. to prescribe her a stronger pain medication. Meanwhile, Dr. D. prescribed the next phase in this journey, another drug called Memantine, or Namenda. She will start this drug tonight, and gradually build up to the suggested dosage.

Meanwhile, I need to start getting organized and work out a plan of action with Dad. This is what I'm willing to do and want to do. I am in a position to help, and Dad and Mom need it. So, I'll stop writing for now, and soon I will go over to their house and stay with Mom so Dad can go pick up the pills and buy foods for dinner. Hopefully something with curry. Dr. D. says studies show that curry is good for the brain. :)