Tuesday, December 20, 2011

Quality of Life X 4

It might be more appropriate to entitle this "My Time to Whine" but I really don't want to do that. Whine, that is. I truly have little to whine about. I do feel grateful for life and where I'm at in it. Not rich. Not poor. Not unhealthy but not without problems either. I'm due to see my oncologist next week for my 3 month check up on the status of my MDS. I have a few aches and pains that are uncomfortable now and then but my layman's brain has diagnosed them as arthritis related and my occasional intake of Tylenol Arthritis pills seems to take the edge off of the discomfort. I've lived longer than my father, than his father, and both of their fathers so I'm grateful for that. Not that they didn't live longer but that I have managed to survive as long as I have and, bar drowning in dishwater or slipping in the shower, I think I might survive for another few days or so. Thus, all in all, I've really got it pretty good. I'm not depressed or at least if I am I don't recognize it as such. I have a fairly optimistic outlook for the future with the possible exception of the political rhetoric that is starting to brew and will boil over to interrupt my favorite TV programs as we approach the presidential elections next Fall. Overall, I would rate my quality of life at 9 on the Richter Scale. If I won the lotto it might increase to 10 but I'm not counting on it. If there is any stress in my life that will shorten my longevity it has more to do with the other three members of our household; wife, mother in law, or the dog.

Starting with the dog, Lucy. She has bone cancer. She's had a history of cancers that we've been able to combat with surgeries. But this one has started in her skull and appears to be moving into the nasal cavity. As a result, her left eye is starting to bulge, most likely because the growing tumor is pushing outward from behind the eye socket. No surgery is going to cure it. Chemotherapy would be a possible treatment to extend her life but nobody can say how much more time it might give her. We have surpassed $3000 in total veterinary costs for Lucy since we started caring for her this past summer. We don't feel it's in her best interest from this point on to do anything except protect her from pain and discomfort. It's really hard to tell when a dog is in pain. She doesn't cry. She still has a big appetite (per the vet mostly because of the steroids she's on) and loves treats, naps, walks, and cuddling. So as long as she's happy and appears to enjoy her quality of life, then we want to keep administering prescribed meds, feeding her "human" food along with her dog food (as recommended by the vet), and spoiling her rotten for as many days she might have left.

Now for mother in law. Eighty-nine years old and in pain. Constant pain. Worse than "aches & pains" an 89 year old person should have to endure. We've known for years she's had osteoporosis. After months of testing it finally appears that there are some small fractures in the sacral area where the vertebrae connect to the hip. She has fallen a few times over the past few years but since there was no out and out hip or pelvis breaks, I think most of her doctors have subscribed to the elderly aches & pains diagnosis. Now they're starting to catch on that the pain is real and the cause is cracked bones. She lives with us and the pain in our town home which means she has a set of stairs to go up and down at least once each day to utilize sleeping floor and living floor. There are still consultations scheduled to discuss the breaking (no pun intended) news and what to do about it. Just recently her doctor(s) have prescribed a wheel chair to minimize walking. And finally some real pain medicines more powerful than the first one they issued which was a duplicate of the pain pills we are giving Lucy! And that makes me wonder if Lucy is getting a raw deal. But we're talking about my wife's mother, now and where to go from here raises a lot of questions. If the stairs become impassible, what then? Block off a section of our living room/dining room for her to live in? With only a half bath on the first floor that would mean no showers. Do we install some kind of stair lift system so she can ride up or down? Could be a tad expnsesive.  Do we confine her to the second floor and bring her meals up to her? I think she'd go stir crazy if we did that. But she can't get into her tub anymore so we've made our shower in the master bedroom available to her so she can shower. She can't really prepare meals for herself anymore so my wife does that for her. But what has happened from all this is that my wife has become a nurse, 24/7. On the few occasions where we've been able to get away from the house for more than an hour or two we've been fortunate that our daughter has been able to look after her grandmother.  She's not senile but she's forgetful, not disoriented but has balance problems. Unlike Lucy, she does moan when she's in pain and it's pitiful to listen too. But if you ask her what's wrong or how can we help she just says her back hurts. She can't be left alone for extended periods of time, say more than two hours, or she might do something stupid. And dangerous. The other day my wife was on the phone with her mother's doctor office and her mother decided to come down the stairs without any assistance. She was half way down when we noticed and were able to intercept and assist her the rest of the way. But when she was asked if she knew she wasn't supposed to descend the stairs without help she said "she forgot." She's not stubborn. Not too much anyway. She just doesn't pay too much attention to rules, details, or what one foot is doing or the other.

My wife has become a nurse. She loves Lucy as much as I do and worries about her the same as me. She loves her mother deeply and wants to do everything she can to enable her to retain her dignity and live a comfortable life.  She feels putting her into a nursing home environment would be a betrayal of trust. Despite the fact that her mother tells her (when she's frustrated with something) to "just cart me off to the nursing home and be done with it" that she can't afford a nursing home so she's stuck with us. She's comfortable with us, we get along, all four of us. Mother in law loves to pet Lucy and Lucy loves to be petted so they form a good team. Out of the four of us I think the biggest strain is on my wife. Of all of us, her quality of life is the most in jeopardy. Lucy doesn't know she's dieing. Mother in law knows she's in pain a lot but has my wife to take care of her needs. I asked her what she wanted to do with herself when she didn't have Lucy or her mom to take care of anymore. At the same time I asked I hoped I wouldn't become her next patient. But she didn't have an answer. She basically thinks it's her duty to keep taking care of her mother and keep her out of a nursing home. I'm not sure that's the healthiest thing for the nurse. But it's her decision. I'll help however I can. But my gut tells me the quality of all of our lives would, at some point, be better served by the nursing home option. We'll see,

I won't be sharing this post on facebook.