Mom & Me Five Archive

    I want to bring your attention to the comment left by Mona of The Tangled Neuron on a recent post in which I discussed actions I intend to take regarding bring my mother's cholesterol a bit more in line (if that's possible). Mona left the comment this morning, and I had to grin because, last night, well...
    Yet again, as I have the last few days, I brought up for general discussion in our household the subject of, as Mona puts it, "tweak"-ing Mom's diet and life style towards the end of lowering her cholesterol numbers, at least a little bit. I began by saying, "You know, Mom, your doctor has never been shocked by your cholesterol numbers, but he was this time."
    "Does him good," she responded. "Doctor's should be shocked from time to time."
    "Well, I was shocked, too."
    "I know. You have a low threshold for that kind of thing."
    Actually, I don't, and, in fact, my high shock tolerance is, I think, a definite benefit in being my mother's companion, caregiver and, especially, medical advocate, but I let this one go. "So, you know, Mom, moving around a little more will also bring your cholesterol down."
    "Yes," she said, sighing, "I'm sure it would."
    "Mom," I continued, putting on my best diplomatic tuxedo, "I know you're at a point in your life where you don't really want to move around much, anymore. I know that it can be more unpleasant for you to move than it is for you to sit still. I know you're 'of an age'..."
    "Watch it, girl," she interrrupted...
    ...I smiled, "...where it could be argued that movement isn't necessarily going to improve your life significantly, maybe not even noticeably, although this is completely against what medical science has determined..."
    "...and we all know how dependable medical science is," she said with a lopsided sneer...
    "...I know, I know, but..."
    "...you want me to do it for you."
    I had to laugh. This took me by surprise. "Yeah, Mom, you caught me, I want you to do it for me."
    She sighed. I'm sure my display of disarmament had something to do with her generous detente, "All right. We'll give it a try. Again. For you."
    I thought it might help if I included, "You know, Mom, you've mentioned, lately that you're looking forward to getting outside in the yard. That involves movement, you know."
    "Don't push you're luck," she warned. "I could just as easily decide to do what I want to do for me."
    Point taken.
    So, you know, there's something that, lately, has been swirling around in my mind, a point made by Anne Robertson in one of her lately published books, God's Top Ten, that we've read and enjoyed, a point with which I agree, that a person's age should not be used as an excuse for withholding the best of medical care and life style improvements. Sometimes, though, it's a challenge to balance this against the sturdy will and implacable spirit of an Ancient One, such as my mother, who believes (and is probably right) that the way she's lived her life is exactly why she is, now, standing on the threshold of her tenth decade. What makes it even more challenging is that I agree with my mother, as well, and am sure that her longevity has little to do with her medical conditions and much to do with her continued refusal to face her own mortality. So, what do you do? You ask her to do it for you...and hope she tolerates you enough to assent, for at least awhile...
    Later.

    Not that I ever said, "Never," but my intention, as some of my regular readers know, has been to try to focus away from Alzheimer's caregiving, lately. Today, though, I was solicited by Kathy Hatfield, who began a blog, KnowItAlz.com Blog in January of this year focusing on taking care of her father, who has been diagnosed with Alzheimer's and remains, at this time, in the early stages. I read through it and, once again, I'm impressed. She is relentlessly positive, which I know many people find helpful, she writes short, clean posts and her observed goal is to load her journal with practical, inspirational tips and suggestions culled from her own life. She is extremely successful in this endeavor. She also has a gift for finding the light type of humor in her caregiving adventure with her father.
    I'm adding it to my Honorable Alzheimer's Blogs, although this one, as does my first entry in Honorable Caregiver Blogs, has duel applications. As well, Kathy is particularly well versed in the support group area, so her blog is a good place to start if you're looking for information about support groups. She has even linked to a chat support that looks promising for those of you who find support groups valuable.
    Later.

...latest doctor's appointment blood draw are up at the immediately previous link. I covered the highlights a few posts back. As I was entering them, using last September's tests as a template, I noticed that she tested worse then, too, in regard to her anemia indicators, than she tends to up here. I'm not sure why that is, but, you know, whatever. Her doctor's scribbled notes on one of the pages indicated that he considers her liver and kidneys "OK", as well as her anemia. I wasn't pleased that her hematocrit was at 30.0, though. Generally, when someone is on dialysis for renal failure, anything below 30.0 is considered grounds for EPO shots. Not that this would be a problem, but I'm a little alarmed. I'm going to see to it, of course, that we're more meticulous about her routine blood draws every month, for awhile, targeting April 23rd for the next one. I expect she'll look much better, by then.
    I read a little on some of the lows and highs that showed up this time, specifically her cholesterol readings. It seems that the Lipid Panel is supposed to be administered to a fasting patient and eating within the 12 hour period previous to the blood draw can be a problem. This always happens, though, when we have a doctor's appointment. I'm thinking that it might be a good idea, when blood is drawn in September, to suggest that he write an Rx for the Lipid Panel so I can take her in up here after her normal fasting from night to morning. Even after a 12 hour fast, though, I'm sure all her cholesterol readings are way out of whack. She has, occasionally, come in normal but always when she's been ill, which is usually accompanied by loss of appetite and a severe drop in food intake over a period of time. This isn't the best way to bring her under control. I'm also taking into consideration Mona's writing on the coincidence of low vs. high cholesterol readings in connection with Alzheimer's/dementia, even though much of this is speculation. I do know that my mother's cholesterol has pretty much always run high, at least in her elder years. Previous to this, cholesterol tests weren't administered nearly as often and, as far as I know, none exist in any of her records previous to her officially entering her elder years.
    However, I will keep a closer watch on her diet. As I was reviewing the results with MCS today, I recalled that we've already cut back quite a bit on cheese, for no other reason than Mom hasn't been particularly interested in it. Meat, of course, is a problem, and we can go a bit leaner at dinner without risking complaints, I think. Other than that, the main culprit is her breakfast bacon and I've already mentioned the solution for that. Out of curiosity, today I surveyed Mom about varieties of breakfasts which don't include eggs or bacon, such as oatmeal with fruit, breakfast cereal (I mentioned her favorite, Grape Nuts), using 2%, 1% or skim milk on cereal (her preference is half and half, or whole milk, in a pinch), breakfasts which are, chiefly, fruit and nuts and maybe home made oat muffins, etc. Her response? "You can eat those, if you want [How generous of her, yes?!?], but I'll stick with my eggs and bacon." So, there. That's settled. We'll definitely begin substituting Canadian bacon. Turkey and soy bacon aren't possibilities...we've already tried those and Mom is not a fan of anything that masquerades as breakfast meat.
    My assumption is that, as long as her appetite is healthy, we'll probably never get her cholesterol within approved limits, but I share her PCP's alarm at her triglycerides, this time, and I think we can do something about getting all her cholesterol indicators close enough in line so that, at least, her LDL can be calculated without doing a direct LDL test.
    I know, I still have lots to make up. It snowed this evening by surprise and it looks like we're in for a cold weekend, as well, Mom is responding to the sudden return of winter weather as usual, slowing down quite a bit, so I'm hoping to do some much needed catching up both here and over at The Dailies over the weekend. Do I hear someone whispering, "Yeah, we've heard that before..." I know. You have. What can I say, except...
    ...later.

...that I am finally able to initiate an Honorable Caregiver Blogs section over at the main, current journal. It's on the right in my links section, premiering with a handy-dandy resource, just above the Honorable Alzheimer's Blogs. Mona of The Tangled Neuron just introduced me to an extremely practical blog effort, GearAbility, authored by marty. It features posts about dealing with the accoutrements of caregiving and includes reviews, evaluation processes, marty's personal ruminations as her dad's caregiver in regard to the products mentioned, the circumstances they might address and outbound links to almost everything mentioned. My favorite post, so far, is the most recent, as it discusses a common problem, one I've experienced, seducing the reluctant Ancient One into therapeutic play. Another about coloring books for adults caught my eye, as well, since the paint-by-number sets MFS sent us seem to be problematic for my mother, even when I substitute blank canvas for the numbered ones; something about the challenge of having to consider several tools and processes at once, I think, and, she has a tendency to obsess about the possible mess. I'm pleased to be reminded that coloring books for adults exist and might be a viable alternative to painting. Further, I feel silly that I didn't think of this. It's always enlightening to look at it from someone else's perspective.
    A belated welcome, marty, to the caregiver blog genre. Very unique, useful and well written addition!

    I started a review of Mom's Doctor's Appointment Day (which went well, thank you), at one minute before 0600 on 3/23/07. It's still in drafts. It will be finished. Not sure when, sometime this week, I imagine. As well, I have a promise to keep regarding publishing about medical funding which I expect will be honored later this week as well. I got distracted, which I'll address in a minute, because the distraction is important.
    We received a call from Mom's PCP's office this morning with sketchy results of the various blood tests her doctor performed. Although the office person who called reported that, overall, the doctor was "pleased" and pronounced Mom as doing well, I'm a little surprised. I didn't write down the results, as they'll be arriving in the mail probably toward the end of the week. This is what I recall from the conversation, though:

• HA1c: 5.2. The office reporter declared this "good", and it is better than September's reading. I recall her doctor, at the time, mentioning that he'd like to see her a little closer to 6.0, which she is.
• Her hemoglobin, though, dropped, within the space of less than a week, from 10.9 to 10.2. He clearly mentioned, at her appointment (previous to these most current results) that he prefers to see her in the 10-12 range, if not higher. I'm a bit alarmed by the drop, too, although it could have to do with her aspirin intake over the few days preceding the appointment. She'd been moving more, thus, her back and knees were bothering her more than usual. For two days before and the day of the appointment I gave her adult aspirin at breakfast instead of her usual 81 mg dose. The day before she received an adult aspirin at night, as well, and yet again another adult aspirin in the morning. This could explain the drop in hemoglobin.
• The office reporter told me, without numbers (for which I didn't ask), that her cholesterol was "a little high" and that Mom's doctor recommended cutting down on fats. This is going to be interesting because the healthier her diet becomes, the lower her HA1c drops. I'm curious to see these numbers, because, in September, although her overall cholesterol was slightly above normal, her triglycerides were zooming, and yet her doctor explicitly wrote next to that number not to worry. My guess is that her overall cholesterol has climbed and her triglycerides may be in the stratosphere. I'm not exactly sure how to moderate this and keep her HA1c up. I've already decided to switch her from regular bacon to Canadian bacon and increase sugar by increasing fruit, which is one of the strategies I used this time. Of course, the holidays also figured into this cholesterol reading, but this last holiday season was not nearly as gastromically rambunctious as have been previous seasons.

    My chief distraction, other than recovering from my post Doctor's Appointment Day exhaustion, was caused by viewing the movie An Inconvenient Truth, which we rented over the weekend. Mom liked the movie as much as she likes popular science program, which is to say, so much that we viewed it at least three times. My reaction was, overtly, similar to that of most people viewing the movie and the slide show on which it was based, I imagine: shocked, sobered and scared. However, I had a covert reaction that, apparently, not very many people had, triggered by the use of the Upton Sinclair quote used toward the beginning of the movie and the Mark Twain quote used further on: I wondered, If, as Gore states, there is so little controversy and the controversy about this issue is so suspect, why is he coming out of the gate condemning controversy? When he used the Mark Twain quote to support his position I thought, I wonder what would happen if I reversed the tables and attempted to apply both quotes to what Gore has to say? The thing is, I cut my political teeth on Upton Sinclair (among others) when I was in junior high, so you have to be careful around me when you use him in my presence. After our first watching of the movie, I expressed my suspicions to Mom and told her we'd be watching the movie a few more times while I performed some internet research on the subject. She was not only agreeable, she was chomping at the bit.
    Mind you, I'm as much of a fan of the horror genre as the next guy. I love to be chilled and frightened, especially if the provocation is well done. Combine horror with documentary and I'm yours. But, tell me there's no controversy then defend yourself against controversy and the horror and the documentary aspects of a presentation lose their edge for me and I start to think.
    As well, since I hadn't previously researched the subject, I'd had no reason, up until the last few days, to doubt the detail of the global warming proposition. All I've done, as have most people, is worry about it and wonder if the individual steps Mom and I take to lighten our carbon load on the atmosphere are effective.
    It was, therefore, with much surprise that, upon typing the search terms "global warming" and "controversy" into a search engine, up popped "1,100,000" references. Needless to say, I followed only the uppermost and, of those, few, relative to the number of references cited. Quite a few were from Wikipedia, since there is an article with multiple links named for my search terms. This, however, was not my only source, nor was the infamous (to the environmental community, anyway) Dr. Richard Lindzen the only scientist I accessed. The media has, indeed, not been silent on the controversy. A variety of newspapers, magazines, and websites have spoken out on the controversy, despite what some of the scientists feel. While it is true, as Gore asserts, that scientific opinion is in agreement about the fact of global warming, the preliminary list of scientists who dissent with various details of global warming, including explanations of what constitutes global warming, what's causing it and what reliable predictions can be made from what we now know, factoring in the voluminous category of what we don't understand and don't know, is not insignificant. In addition, Wikipedia has published a list of "Former Global Warming Skeptics". It is interesting to note that although a few science writers people this list, no scientists are on it.
    It seems that Gore's delineation of the global warming phenomenon is so simplified as to be inaccurate, at least. The influence of the greenhouse gases he mentions, particularly CO2, is in dispute. The documentary is negligent, as well, in paying almost no attention to what the meteorological community considers the most important factor involved in global warming, atmospheric moisture. Several "dissenting" scientists note that Gore gives little attention, as well, to atmospheric dust, which is closely related to atmospheric moisture. Even his predictive models are widely disputed and some of them have not been able to be duplicated, which is a foremost requirement of rigorous scientific method.
    His citing of recorded soaring temperatures over the last few years centers on the use of cities. The urban heat island effect is not disputed by science and is of much concern. What is disputed is its effect on the rest of Earth.
    Gore certainly gets it right when he asserts that global warming is a political issue. Thus, I read the entire Kyoto Protocol. I was astonished. This is not a prescriptive document for reducing global warming, I realized, it is a political document designed primarily to force developed nations into subsidizing the economic prosperity of developing nations. As such, there is much doubt within the scientific community that it will have any observable effect on reducing global warming.
    Other curious observations:

• It seems that the Alps' and Greenland's glacial fields have, within recent years, been observed to be advancing, rather than continuing their retreat.
• Gore's models have already inaccurately predicted the extent to which Earth should have already warmed.
• He neglects to mention a crucial cooling period in mid-century which led to a "cooling hysteria" just previous to the warming hysteria.
• Earth's tropospheric temperature, which is considered crucial in determining periods of warming and cooling, has varied only insignificantly during the time period Gore cites.
• The same is true of ocean temperature.
• While Gore lauds China for their CO2 standards in regard to automobiles, there is mounting evidence that China will, in the not too distant future, surpass even the U.S. in greenhouse gas emissions from other sources.

    Serendipitously, at my mother's doctor's office last Thursday, we were treated to an entertaining story told by one of the occupants in the lobby who, along with most of the rest of us, was waiting on an unaccustomed, unpredicted, ferocious downpour to end before leaving the office. All of us were talking among ourselves about how surprising this downpour was, considering that it hadn't been predicted. This man spoke up and told of a famous TV news weatherman in his home state whose first name was Leonard. He accepted a viewer's challenge regarding his accuracy as a weather predictor. The viewer, over a specified period of time of which I can't recall, kept a record of how many times Leonard's predictions were accurate. At the end of the challenge period, Leonard's accuracy turned out to be 42%, whereupon Leonard was dubbed "Lying Leonard". The truth is, the science of weather prediction routinely scores well below 50% in the short run. How in the world, one of the global warming sources I accessed asks, can we expect to rely on predictions which take into consideration months, years, decades, even centuries? Good point.
    There is even dispute about whether reducing CO2 emissions is a good thing. Some scientists consider that global warming may, in fact, be good for humanity and nothing more than business as usual for Earth. Others think the effect may be so easily and quickly overcome within the human community as to be negligible. All of the dissenting scientists agree, though, that the issue of global warming is surrounded by such political hysteria, at this time, that efforts to research the issue effectively are being stifled.
    As I continued my reading, I was reminded of Galileo Galilei and his dispute with the political force of his time and place, the Catholic Church, over heliocentrism. Considering that the position of the Church did not reflect the position of individual members of the church, including the reigning pope, nor the populace at large, all of whom had long ago accepted the Copernican thesis, the trial was essentially a witch hunt within the context of the much larger issue of who held political sway.
    My developing feelings regarding global warming are this: We do not need to scare humanity with a loose cannon in order to observe and address that we have, indeed, created enormous problems for ourselves and other species by raping our environment for economic gain. Some of these problems are: An increasing lack of potable water and arable land; an unusual ascendance of illness linked to environmental factors, particularly, but not exclusively, asthma and cancer; extremes of political unrest which can be directly attributed to unusually swift environmental change clearly perpetuated by activities intended to increase economic development in developing and developed nations; the alarming disappearance of species, such as bees, upon which we rely to produce the elements of survival. All these problems need to be addressed. The need is urgent. One of the larger problems inherent in addressing them is the current "survival of the fittest" economic model, in which wealth is defined by, yes, Al, "gold", under which most of our species labors and which Gore does not address. If anything, Gore predicts that this model could and should become healthier if his global warming platform is embraced.
    We've got problems. They are global problems. I think that our attempts to gather these problems under one questionable umbrella and christen that umbrella "global warming" are actually deflecting our efforts, especially the science and economics of our efforts, to solve these problems. My reading of the Kyoto Protocol and its delineation through Wikipedia (the immediately previous link) leads me to believe that this treaty will probably do more to undercut our eventual solutions to these problems rather than advance them.
    If our history as a species has taught us anything, it is that we cannot do credit to our desires if we discredit dissent, especially scientific dissent, during the problem solving process. From my point of view, the inconvenient truth is this: Hysteria does not advance our ability to deal with these problems, but it is exactly what Gore's movie is designed to produce. Further, without serious, unsettling economic considerations, we, as a species, will have no chance of solving the problems with which we have beset not only our species but other species and the global environment. It is important that we realize, as well, that Earth doesn't consider humanity's life style a problem. Earth is apolitical, amoral. To Earth, we are simply a circumstance, to which other circumstances are created in response. Those "other circumstances" may well spell out our eventual extinction, even if we work seriously and apply ourselves with utmost sincerity of purpose to the desire to keep our species and what we think of as our beloved but currently fragile environment in existence. It would do us well to consider the following:

11 x 11 - 11 (66)
Do not fear your rage. It barely penetrates
the earth’s skin, even as it reverberates
in canyons, in ears. I transform violence.
It carries my own ecclesiastical
lament. It swirls a thrilling shudder through me.
I am within the pit. I am the ocean.
Why would you think I would not want you to dive
into me? I was made to encompass you,
adore you. When you think you have plundered me
lifeless, I will absorb you, your chemicals,
and brew another batch of sentient soup.

    Can we humans cool our hot headed devotion to rhetoric over reason, prophecy over practicality, oration over observation, conflict over cooperation?
    Let us try.
    What does all this have to do with my mother? Well, she's been here with me through all of this. And, as well, this is my excuse for not reporting in more depth on her.
    Later.

Added April 11, 2007
    I continue to research opinions about global warming, as I can; both sides of the issue. I just discovered an interesting blog entry entitled How to Talk to a Global Warming Skeptic that is very helpful. I'm just now making my way through the exhaustive list of references. My contention remains that, whatever the cause of what we are currently referring to as global warming, the problems to life, human and other, are obvious and need to be addressed, regardless. We also need to be much more wary about the solutions we propose. I am offended, for instance, by the idea of "credits" being issued that can be traded about in order to reduce one country's responsibility while heightening that of another. Responsibility, I believe, should remain global. It seems these credits are also applicable to businesses and individuals in the form of carbon offsets (also called "green tags"). It seems to me that buying one's way out of the disappearance of livable habitat is a solution that delays responsibility. Humans are famous for cheating when it comes to money: Tweak a spreadsheet here, revise a number there, obfuscate the evidence in an exhausting series of numbers and formulae and no one has to do anything while the earth becomes less and less able to reliably sustain life as we know it and apparently love it.
    In the meantime, over the last couple of weeks I've changed out all our light bulbs, except for those in the dinette on a dimmer switch (I have yet to find bulbs locally that work in these sockets). Couldn't hurt, right? This has created a minor problem in that, by the light of the curly bulbs, Mom perpetually looks anemic. As you know, her anemia profile has lately been a matter of concern for me; so, in the evening I find myself herding her into the dinette so I can take a look at her under light to which my skin reading skills are better adapted. A side benefit of this is that she gets a little more exercise. It also keeps her humor up. She thinks it is incredibly silly that I insist on doing this.
    As well, I've begun to contemplate the end credits tag on An Inconvenient Truth that implores "children" to ask their "parents" why they would want to endanger the existence of their progeny (a shameless paraphrase, I admit). Funny, but I discovered that the originator of Earth Day, Gaylord Nelson, was of my mother's generation, born in 1914. His extremely important collaborator, Denis Hayes, who is responsible for the mechanics that launched the original Earth Day and revived the movement in the 1990's, is of my generation, born in 1944. So, you know, don't ask me this question. It's obvious to me that there is no generation specifically responsible for either the destruction of livable habitat, nor for efforts to abate the destruction. We're all culpable, including our children, for what we perceive as a looming crisis. Thus, we're all responsible. Now, if we could just get the money issue out of the picture, we might actually accomplish something of value and meaning.
    Yeah, right.
    Later.