Mind vs. Body
What's in a name?
I took mom to her annual well-check visit with Dr. K yesterday (well, last week by the time this post goes up). We call her "Dr. K" because her Indian name is a bit challenging for mom to pronounce, but she's been working on it. I haven't seen or heard her actually doing it, but I think she might be silently practicing it as she moves around the house in the morning before my dad wakes up and Hannah, their caregiver, arrives. She likes to take on these small challenges and work at them until she gets them right.
As we turned up the main road back to their house on the way home, she said it, hesitantly on the last syllable, but she got it right. It was in the context of her saying how much she really likes, even loves, Dr. K, even if a lot of the time she can't quite keep up with what she's saying. I couldn't help myself when she said the name: "Ha! You got it! That's great, Mom!!"
Driving = Winning
It's the same with her getting back to driving. After her pacemaker surgery early this year, she was not to drive until the implant was fully healed. That recovery was followed by two months of cataract surgery preparation and recovery, blended in with her official dementia diagnosis. Though her eye doctor cleared her to drive - if she wanted to - between and after each cataract surgery, the earlier post-pacemaker instruction remained firmly lodged in her mental instruction-book.
It was mildly ironic that her halting, yet resolute decision to start driving again came after the geriatric psychologist suggested that I, or even a professional evaluator, should assess her capabilities behind the wheel before she made that leap. After 54 years, I know my mother. I told her anytime she was ready, I would ride with her. We've developed a pattern, though, of me driving her when we're together - going to doctors appointments, running errands; so she would feel quite strange, and I'm sure extra-nervous, if suddenly I were sitting in the passenger seat, scrutinizing her every move.
I gave her space. On Mother's Day we discovered the battery in her car was dead. We jumped it, and I drove her and my dad in it to their favorite restaurant to meet up with my husband and boys for dinner. She then took it upon herself to start the car each day over the next week, serving the dual purpose of ensuring the battery held its charge, and re-charging her own familiarity with sitting in that seat. One day that week she told me, with a combination of excitement and guilt, that she'd backed it out of the garage, then pulled it back in. I told her I thought that was great.
Memorial Day weekend came, and we planned for them to join us here at my house for a cookout that Sunday. She hadn't gone any further at that point than backing the car out of the garage and returning it to its spot. When we spoke that morning, I asked, "Do you want me to come down to get you guys, or do you feel ready to drive?" "Oh no," came the reply. "I'm ready." I sensed a hint of hesitation in her voice, so I offered, "if you start down the hill when you leave to come over and feel too nervous, don't worry. Just call me and I can come down and get you. And if you get here and then feel like you aren't ready to drive back later, don't worry, I can always drive you back." (They live 3 minutes away).
When they arrived that afternoon, her sense of accomplishment was obvious to me. Later, as they were getting ready to leave, I asked her if she felt comfortable driving and this time there was no hesitation at all. That week, she took herself grocery shopping for the first time since early January - a "big shop." Last weekend, my dad called to inform me that she'd run out to pick up grinders at Jersey Mike's - an uncomplicated drive, but a spot she'd only been once, and farther away than the grocery store, though we'd talked a few times about its location before we visited it the first time. Since he'd never been there himself, Dad wanted to know how long he should give her to come back before he got worried. So cute. I did some calculations and gave him a time. She made it back, uneventfully, and with their favorite sandwiches.
She needs to push herself in these ways; I understand. She needs to prove to herself that she can do it. That her mind and body aren't totally abandoning her. She's careful though, and has been uncomfortable with highway driving for quite a long time, so I'm not worried she's going to set off on a dangerous cross-state-line odyssey.
Having a plan is good
We talked a little bit about it at Dr. K's yesterday, while we waited for the doctor to come in after the nurse, Beth's, initial vitals check. I told mom I thought she was doing great with the driving, but reminded her that if she ever felt like she was starting to get confused out there, I'd always be around to take her where she needed to go. She said she wouldn't want to disrupt my life like that, and I emphasized that it wasn't a bother - that my schedule is flexible - and she arrived at a future compromise herself that seemed to satisfy her: "If it comes to that, we can set up a. . . "(she reached for the words) "a way so we do it at a certain time. . ." I chimed in: "Like a weekly schedule! Grocery shopping on Tuesday, or whenever!" "Yes - like that," she said. I could tell she felt good about having a plan. It wouldn't be the only one to come out of the day.
Dr. K came in, and among the litany of well-visit discussion items, she reviewed, and came up with a plan for, the two other things that mom's May chest CT scan had divulged, besides the thyroid nodule, which we're already addressing. I had shared all three things with mom at the time they were discovered: a small nodule in the lung which appeared to be early-stage emphysema; something in the gall bladder that presented like a gall stone; the nodule in the thyroid.
Mind over Body
Of course, because at the time the doctor was most concerned with the thyroid nodule, and following up on that became our focus over the past month (ultrasound, biopsy, visit to endocrinologist), she forgot, quite completely, as it turns out, about the lung and the gall bladder. Truthfully, I must have been off my game yesterday, because if I were thinking, I'd have reminded her as we drove to the appointment that those two things would be on the discussion list. But, I didn't, so she was caught off-guard.
As we walked out to the car afterward, she said, "I didn't realize about my lung and gall bladder." I reminded her we'd talked about how strange the emphysema was, since she never smoked, but my grandfather and father had, so we'd concluded the second-hand smoke was a likely culprit. I also reminded her that she's having no symptoms for either issue: no unusual shortness of breath, no abdominal pain, and as long as she feels good, right now, that's what counts more than anything. We have a follow up plan for all 3. And, as with the thyroid, we just need to pay attention and if anything changes (difficulty swallowing, shortness of breath, upper abdominal pain), we'll let the doctor know.
Still, she feels like her body is betraying her. She says, half joking, half in despair, that she doesn't think there's anything left "in there" that can go wrong. I chide her with a smile and tell her to cut that out and knock on wood. As long as she feels good, I tell her again, that's what counts. I change the subject to getting her planters ready on her deck, and remind her to go to the farm stand tomorrow to pick up her tomato and herb plants. Something she can control.
