Parenting the Parents, Part XIV. Thyroid Nodules and Escape Acts.

Time for some positive energy for a couple of reasons: 1) Mom’s thyroid ultrasound was Wednesday. She has a 3cm nodule (medical code for a tumor, and 3cm isn’t a tiny one) that is defined as “complex.” While that doesn’t necessarily mean cancer, it could. I should be getting a call from the doctor’s office today or tomorrow to schedule a needle biopsy. 2) On Tuesday night, sometime around 3 a.m., for the first time, dad wandered out of the house.

Not the worst thing. . . maybe

Let me take these one at a time. First, mom’s thyroid: Isuspected things might begin to unfold like this when the doctor called me lastTuesday evening while we were on vacation, filling me in on what he was seeingfrom the CT scan mom had had the previous Friday, and letting me know that thethyroid ultrasound was in order. If there were nothing concerning in that CTscan, I’m pretty sure a follow up call might not have come at all, or wouldn’thave been quite so soon. So, when the doctor called last night, on the same dayas the ultrasound, I was certain it wasn’t just to convey an all-clear.

Now, I do realize that of all the vast array of cancer possibilities that exist, thyroid cancer isn’t the worst. The majority of thyroid cancers are highly treatable and, overall, have a 98% 5-year survival rate. I also know this survival rate can be quite different depending upon the specific type of cancer, stage, and the age of the patient. No matter what, all we can do is take this one step at a time. I decided not to tell mom about it last night so she wouldn’t stress out and keep herself awake. (I’ll tell her as soon as I hear from the doctor’s office and have the biopsy appointment set up. I did prepare her for this possibility after the ultrasound, so hopefully it won't come as a shock).

Secret Houdini

As for dad and his . . . expedition, Mom slept right through it, and only discovered it when, in the morning, she looked out the front window to see if the newspaper was on the stoop and saw his walker, sitting on the sidewalk, dripping from the rain and mist that had persisted all night. He had come back in and by then was snoozing in bed, but immediate action was clearly in order to prevent another such incident, possibly with a much worse outcome. When mom asked him why the walker was outside, he told her, in full detail, how he’d gone out and exactly where he’d gone (farther than he’s probably walked cumulatively over the past month). The one thing he couldn’t tell her: why he decided that he simply had to go for a walk, outside, in the cold drizzle, at 3 a.m. I think he was bored.

How someone with very limited agility managed to Houdini himself - and his walker - out the door, down the (thankfully only 2) steps to the sidewalk, then on a downhill trek with an uphill return that spanned about 400 yards round trip, unaided, is beyond me. I forgot to ask him what he had on his feet!

The Solution, for Now

There are two exit doors on their main floor (and a bank ofsliders in the walk-out basement, but we keep the basement door locked with atwo-sided, keyed lock so dad doesn’t accidentally open it and fall, thinking it’sa door to somewhere else). The front door has a deadbolt with a flip lock onthe inside, and the garage door has a regular knob-lock, like one you’d find onmost bedroom or bathroom doors, but with a keyed entry on the outside. Ithought at first that we’d change the front door deadbolt to one that’s keyedon both sides, along with switching out the garage door with one similar to theone on the basement door. Mom could wear the keys on her fall-alert pendant.

Upon further thought (and a conversation with the locksetguy at Home Depot), we concluded that having 2 keyed locks could be a hazard ifthere were ever a fire and mom wasn’t able to find the keys (even though, intheory, she’d be wearing them; if she ever took the pendant off and forgot toput it back on, the panic of an emergency would surely obliterate her abilityto think clearly about where she put the pendant and the keys). So as at stop-gapsolution, we bought 2 magnetically activated, stick-up door alarms that go offwhen the door is opened and the magnetic field between the 2 contacts isbroken.

Disarm Alarm

We “installed” the alarms on both doors last night, with the intention of going out today to pick up the double-keyed deadbolt for the front door. We tested the alarms, showed mom how they worked, made sure they were set, and said our goodnights. At 8:50 this morning, my phone rang. It was mom. I picked up with my usual upbeat, “Hey! What’s up?” It took her a good 20 seconds to communicate that she didn't know how to turn off the door alarm, and she was not happy. Oh boy. It wasn’t shrieking in the background as we talked, so obviously she at least remembered that you just need to close the door to make it stop. I couldn't initially determine why simply closing the door was so distasteful, but when I offered that as my first solution to the problem, it riled her up even more than she already had been. Oops. I realized later it was because she wanted to leave it open as she stepped outside and down the stairs to pick up the newspaper.

Her frustration built as she sputtered through what she thought she was supposed to do to disarm the device, none of which was making a shred of sense to me. I thought she was standing in front of the alarm and trying to figure out how to disable it. It took another minute or two of attempting, and failing, to guide her through how to turn off the switch for me to figure out that was what was happening:

“Are you at the actual door looking at the alarm, or readingoff the instructions?”

“Both, but I’m looking at the paper.”

“OK. Put down the paper and just look at the alarm itself andI’ll tell you how to shut it off.”

After another 2 minutes of me trying to walk her through the process, step-by-step, it was clear that absolutely nothing I was saying to her was landing - the circuits were shorting. I told her I’d be down in a couple of minutes.

She was in rare form when I got there – upset and mean-spirited, saying she didn’t care if he just went out the door and never came back. I let that bounce off and said I understood - which took a lot of energy - then showed her (again) how to slide the cover off the alarm (even though she thought we didn’t show her last night), how to move the switch to turn it off, or to switch it to “beep” mode (so it would just beep once if someone opened it). Hugging her, I apologized (I felt for her in her confusion, even if her anger was really getting to me this time), but her dark mood relented only slightly. I told her we’d be back later after we picked up the new deadbolt, and beat a hasty retreat back home to finish my coffee and to steam quietly in my own annoyance.

The Solution, Part II

Tim had taken his niece to the airport, and when hereturned, much to my delight, he announced that he’d bought the deadbolt on theway home. After he finished his coffee and got in a round of post-primersanding on the trim in the hallway-under-renovation, we rolled back down the hill.Hannah, their caregiver, was there by then, and dad was up and sitting at thekitchen table, finishing his breakfast. Mom was nowhere to be found (Tim thinksshe was hiding in the bedroom, feeling a little sheepish over her earlierbehavior – he may be right).

By the time we completed the installation of the newdeadbolt, she’d made an appearance, though with only slight mood improvements. Timand I left to have copies of the key made at the hardware store and picked up alanyard for one copy that would stay in the door during the day and be wornwith her fall button at night. I had one of the copies made with a specialty headdesign in the shape of a little house, with the word “Home” on it, for herregular keychain, to make it easy to differentiate between that one and the onefor the garage. When we got back, I tested both of her keys to be sure theyworked, and she seemed to get a little lift from the “home” key – small victories– though we were still far from “normal.”

I’m considering whether I need to go over there every night to set the alarm on the garage door for her, then go back every morning to turn it off. For dad to get out of the garage and into the world would take a lot more (relative) Houdini-ing than slipping out the front door, so for now I’m content to see how it goes over the next day or so, and look into an alarm mat!