Yes, I’m griping.

I wanted so much for those steroid patches, stuck for 14 hours each on two separate days like limpets to my hips, to work.

I really, really did. I wanted the stuff to KO the bursitis inflammation and pain.

But they didn’t. It sounds nuts, but my hips actually hurt worse while I wore the patches, as if the imperceptible electrical impulses that drove the medicine through my skin and down into the inflamed bursae irritated and aggravated them instead. I even had had ominous RA pain in my groin (originating in the ball-and-socket joint of the hip) when I walked, and at times my bones ached from my hips to my knees down my shins to my ankles.

Just shoot me.

I didn’t mean to pin so much hope on this new therapy—by now, I ought to know better, after all—but I’m so disappointed. And I’m embarrassed, too, a reaction I didn’t expect and which makes me a little angry at myself. See, I have to go back to PT on Wednesday this week and tell Joe that his miracle cure didn’t work on me. That nothing sees to work on me.

Pity-party, anyone? Sheesh. I know I shouldn’t be embarrassed; it’s not my fault that the patches didn’t work. Besides, he already knows the first round failed. I gave him the news on Friday when I went back to the PT clinic for round two of the patches. He said we’d try them one more time, then. If they still didn’t help, we’d stop that particular therapy.

They didn’t. So much for that.

I’m bummed, gang. The ultrasound treatments ordered by the orthopedic surgeon (also as a last-ditch effort) aren’t having the desired effect, either. I do the stretches I’ve been assigned three times a day, but for nothing, it seems. Well, okay, I’m a bit more flexible than I was before I started them, for what that’s worth.

Finally, I haven’t been back to the gym since mom had her emergency stay in the hospital last month. I don’t know if working out is a factor or not. To be honest, I’m sort of afraid to. This current bout of greatly increased bursitis pain started after I began working out at the gym. It might have nothing to do with it, or it might have everything to do with it.

Indecision is my middle name.

The only thing that does work—briefly—is icing. I dread it every time. The icepacks hurt like the blazes for the first five or ten minutes, but by the end of the 20 minute sessions my hips go numb and I can’t feel anything for a half-hour or so.

I’ve got to get my mind around either learning to live with this hip bursitis pain and disability for the foreseeable future or seriously consider surgery to remove the inflamed bursae once and for all. My mind cringes away from the latter, but if I’m honest, the former doesn’t sound like a better option. Sigh.

Okay. Enough. On the bright side, Mom has been feeling fairly well; my cat, Mouse, is a goof, a true clown who makes me laugh frequently; and the deep rose-pink camellias in the back garden are in full, gorgeous bloom. A skunk waddled across the front garden in full daylight one day last week (I thought it was a very large black cat until the big white stripe registered); and my aunt and I named one of the feral cats she feeds on her front porch every morning and evening “Richard Parker,” after the Bengal tiger in The Life of Pi. The cat is a pretty orangey-brown tabby. The name fits him and makes us both chortle. Finally, it rained yet again today, an all-day, soaking downpour that fell as feet of snow up in the high country. This one may have just squeaked us out of a drought summer. My fingers, sore as they are from the roller-coaster barometric pressure ups and downs, are crossed.

 

Hoping to patch things up …

At physical therapy yesterday morning, Joe the PT gave me some good news: my rheumatologist has approved his request to try using steroid patches on my hip bursitis.

I was pleasantly surprised. Dr. McA had previously nixed any further steroid injections or oral steroids, even in short, tapered doses, citing his concern about my active osteoporosis. Corticosteroids cause bone-thinning; with osteoporosis already doing a bang-up job on my bones in that regard, adding even more is a little counter-intuitive.

I completely understood his reasoning, though I was sad that I had to rule out the oral steroid tapers, which had actually provided some relief from the bursitis inflammation and pain, even if it was relatively brief. This most recent decision made me wonder what was different about the patches, which would still put bone-killing steroids into my system?

I asked Joe. He didn’t know—he was just pleased we’d have a chance at perhaps getting this miserable pain under control for me. He’d seen it work before, he said encouragingly. Sweet guy.

The drawback? Although Dr. McA had approved the patches, the pharmacy hadn’t yet filled the prescription—and they could only be applied at the PT clinic. Joe said the time I could wear them for each treatment was strictly limited.

So, I won’t be able to start the patches until next Wednesday. After that, along with my weekly Wednesday appointment, he wants me to come in without an appointment two other days. That way I’ll get three controlled steroid treatments each week.

Cool. The VA medical center is about 20 miles from Mom’s place and less than 10 from my aunt and uncle’s house. So, I’ll be burning a little more gasoline, which will sting a bit with prices rising like they are. But sheesh. If the patches work and I can walk, move and sleep without so much pain, a little more money spent on gas will be totally worth it.

I continued to wonder why I couldn’t use the patches at home, though. Certainly, I could watch the clock and take them off at the prescribed time limit by myself. So might it be because of the amount of steroid in the patch? Might there be so much of it that to risk accidently wearing them too long could seriously harm me? Hmmmm…

I decided to Google.

(Note: As a journalist, I’m very aware that it’s smart to take what you learn on Google with serious skepticism. Not everything you read is correct or—unfortunately—true, and there are lots of less-than-ethical companies and individuals out there who’re ready and willing to lighten your wallet by convincing you that their product will work veritable miracles. There are also a lot of well-intentioned people who write passionately about things they believe to be true which actually aren’t backed up by facts, scientific or otherwise. To protect myself, I try to read no fewer than five different sources of info on the same subject, rejecting any website focused on selling me something, before I accept what I’m learning as fact. My point? The Web is a great source of information, but buyer beware.)

All that said, I love Google. Never before in my lifetime has so much good, solid information been available so quickly and easily. I wish it had been around 25 years ago, when I was first diagnosed with rheumatoid arthritis. I’d have been so much better informed about the disease—and, just as important as far as I’m concerned—I’d have run across blogs written by others with RA. I’d have been able to read their accounts of their daily lives, their frustrations, their hopes and fears, the impact of the disease on their work and families and relationships, and how they coped. I wouldn’t have felt so completely isolated and alone with my pain and disability. What a true life-changer the Internet has been!

Anyway, I googled “steroid patches.” All the information I found referred to steroid patches being attached to a device that produces electrical charges. In a feat of scientific magic, the electricity drives the drug rapidly through the skin and deep into the tissues beneath it, where it does its own magic, drastically reducing the pain-causing inflammation present in the tissues. The process is called “iontophoresis.”

In my case, the tissues involved are the trochanteric bursae.

The advantage to this method of delivering the steroid is that it doesn’t involve the bloodstream, as it would if it were taken orally and (I’m conjecturing here, as I’m not sure) if it were injected directly into the bursae. Though the bursae have virtually no blood supply, some steroid can still leach into the blood.

In addition, with the patches, there’s no risk of infection or injury caused by the needle.

Generally, a steroid patch session lasts 20 to 40 minutes, depending on the amount of drug prescribed, but they can last up to three hours. And while the latest technology can allow patients to wear them away from a clinical setting, carrying the electronic source device in a pocket as it wirelessly transmits the signal that causes electric pulses in the patch, that technology is very expensive. It’s a lot cheaper to use the patches in the clinic. And the VA is, of course, all about fine health care at a reasonable cost.

I can live with that.

In other news, my nortriptyline prescription from the VA pharmacy finally arrived today. I’m looking forward to a much better sleep tonight and for the next month of nights. The bad news? The doc neglected to give me refills on this prescription, too, so I have to contact the pharmacy (and they, him) yet again for enough refills to last until my appointment in June. Sigh …

Overall, though, there is hope on the horizon. If the steroid patches work, I won’t need the sleep-aid anyway. Now that would be good news!

Nighters

It’s Tuesday night. I’m hoping for a good night’s sleep; I have an early physical therapy appointment in the morning, followed by a caregiving day with my aunt and uncle. I enjoy being with them, and the work isn’t difficult or stressful, but these work days tend to be very long. I try not to push myself too hard, but I usually end up worn down to a nub anyway.

Stupid RA. Stupid bursitis. Stupid osteoporosis. The combination is an energy leach, which is why my mind is on sleep tonight.

I’ve always tended to underestimate the importance of healthy sleep. When I was editing the newspaper, 12-to-15-hour-days at the office were my norm. When I finally got home at night I’d be so wound up that it would take me until midnight, at least, to relax enough to settle down and sleep. And then I was back up at 4:30 a.m. to start the whole thing over again, sometimes six days a week.

I loved it. I loved my work. It fulfilled me and gave me joy.

In hindsight, I know that my lack of sleep was self-destructive. Nuts, even. But at the time, I was proud of my toughness, my resilience. Unlike the rest of the human race, I really only needed four or five hours of sleep at night. I was SuperWren!

These days, when my pain levels are under control, I average six to seven hours of sleep each night. I say average, because I do occasionally sleep a full eight. The key, for me, is pain control. The hip bursitis pain I’ve been battling wakes me up and forces me to roll from my hip to my back to my other hip over and over again throughout the night. I drift back to sleep in between, but I never really get to sleep deeply. When morning comes, I’ve been laying down long enough that my body has become incredibly stiff and miserably achy. I get up with relief, but exhausted.

My rheumatologist prescribed nortriptyline, an antidepressant that has deep drowsiness as one almost universal side-effect. General pain relief is another. In my case, both are gifts. It took awhile (read months) to get the dosage to a therapeutic level, but once it was, the stuff worked beautifully. Finally, I was sleeping through every night! No more tossing around! No more laying there awake, aching, watching the clock, wishing that the opiate pain reliever I was taking would work like it used to so I could get some sleep. Nortriptyline saved me.

Well, until about a month ago, when I tried to refill my prescription for those magic capsules and discovered that Dr. McA had forgotten to renew it during my last appointment with him in December.

Oh well, no biggie, I thought. I’ll just get a request for renewal in to him. It won’t take long.

So that’s what I did. The first night I went to bed without my little white capsules, I was a wee bit apprehensive. Would I be able to sleep? To my pleasant surprise, I snoozed the night through without trouble in spite of my very sore hips and very sore RA hands. The same thing happened the next night. And the next. Great! thought I. Either I don’t need the stuff to sleep anymore, or (more realistically), there’s enough of the drug built up in my system to keep me going for a while.

I crossed my fingers that my reserves would last until the prescription was refilled and I had a bottle of the stuff in my hot little hands.

But a full week later, I still didn’t have a new prescription. I put another request in, feeling like a pest but getting kind of worried. And for good reason. A night or two after that second request, I resumed my miserable, ache-induced tossing and turning, losing the ability to sleep deeply and get well-rested. My magical, residual reserve of nortriptyline was totally tapped out.

And so it has been ever since. Dr. McA finally got my requests and refilled the prescription on Monday this week. Since I routinely receive my VA meds by mail, I should get it—hopefully—by Thursday.

I no longer believe that I can SuperWren through my days, handling whatever challenges that come my way on a mere four hours of sleep. I’m about 10 years older than I was when I did that for my job. My RA hurts and affects my bones and body now like it didn’t back then. I was still enjoying remission. And I didn’t have bursitis of the hips, or osteoporosis. I was tougher. And maybe I was a bit dumber, too.

So. Off to bed I toddle, hoping as usual for sleep, older and—I hope—wiser.

Pain as dread

I seem to be going through a sort of transition these days with my rheuma-dragon, that evil old beastie. Although the symptoms he causes have been frequently annoying over the last three or four years, and his grouchy, persistent cousin the bursitis-wyrm has had his sandpaper claws sunk into my hips for the last two, both of them have ratcheted things up during the last six months—and pushed them even higher in the last two weeks.

Yesterday, I endured the highest level of pain I’ve had yet since my 6-year RA remission ended in 2007. A good portion of the flare was in my hips, as usual, caused by the rheuma-related bursitis. But there was a more profound ache within it, centered deeper inside the hip than those small bursal sacs that lay between the ball-and-socket joints and the tendon-secured muscles that run down the sides of the hips to the knee. The worst pain felt like it was inside the joint, inside the bones themselves. If you have RA, you know the sensation—it’s deep, hot, malignant, throbbing and insistent. It’s impossible to ignore. When it’s really bad, it can make moving desperately painful. At times, any pressure on or movement of the affected joint is simply unendurable.

And yet I’m told by my doc that if the RA is really attacking my hips, I’ll feel the pain in my groin, not the joint. I guess I have to believe him (and recent x-rays bear him out), but my whole being is exclaiming “WTF??”

The ache in my hands intensified considerably yesterday, too. No bursitis to blame, there. The pain was pure RA, its dull knives concentrated in the large knuckles of both hands and radiating toward my wrists and fingertips.

And even as ugly and painful as it was yesterday, this flare was a mere shadow of the flares I used to get in the first decade following my diagnosis in the late 80s. Those were Flares with a capitol F. They were Red-Letter Flares. They were memorable.

And I do remember them—well—which I’m sure is part of my problem today. Yes, some of it is “in my head,” unfortunately. Pain as intense as I experienced yesterday raises a sort of creeping, anticipatory dread in the back of my mind. It’s like a black mist that permeates everything in my world. It was because of this insidious fear of once again experiencing that old agony that I sought out a rheumatologist when it became clear that the nasty rheauma-dragon was waking up again after his long hibernation. When it was clear that he was more than a little hungry—he was friggin’ ravenous. I knew I needed help.

My previous experience with RA drugs had been mostly limited to a profoundly ineffective spectrum of NSAIDs (Non-Steroidal-Anti-Inflammatory Drugs), most of which irritated my stomach to the point that I’d dread the awful, sick nausea each dose brought with it. They were Aspirin. Naproxin. Naprosin. And Etc. I finally stopped taking them entirely and turned my back on any further medical intervention. I was that disillusioned, convinced that the busy doctors and their drugs could do nothing for my RA because, frankly, after five years of trying, they hadn’t.

But over the later, remission years I read here and there about the new Disease Modifying Anti-Rheumatic Drugs (DMARDs) for rheumatoid arthritis. When my dragon finally woke again, I was so scared I was willing to try them. I’d heard of the seemingly miraculous Biologics, too. I wanted them all in my arsenal even though I had little hope that they could actually do any good.

And here I am today, roughly three years after consulting with a Veteran’s Administration MD about my RA. I have a terrific VA rheumatologist on my side—and an impressive array of pills. (Their collected bottles inspire a sort of awe in my family. Frankly, I’m awed, too.) I take three different DMARDs. No NSAIDs. I take vitamins and supplements like folic acid. And I have running prescriptions for two separate pain meds, one of them a narcotic. I keep those particular big guns stashed away in a high, dark cupboard. They’re my puny refuge when days like yesterday hit.

Because my daily medicinal cocktail has, until now, kept my RA dragon slow and sleepy and his knife-like teeth blunted, my faith in medical science has been mostly restored. And while I’m aware that alternative therapies, from copper bracelets to herbals and no-nightshade-plants diets to acupuncture and massage, are available, they’ve never worked for me with any surety. (Believe me, like most people with chronic pain and disability, I’ve tried them. I’d never discourage anyone else from trying them, either, since such things work in such an individualized way on this demented disease.) At this time in my life, I’m relying on medical science and the pharmaceutical companies. I’m convinced that the drugs they’re providing are keeping the worst symptoms and effects of my RA at bay, even though there are a few serious flaws in the armor.

Nevertheless, yesterday’s serious pain in my hands and hips (and briefly, both knees) was a heads-up. Over the last six months I’ve relaxed and let my weight creep back up, allowing yummy but less-than-nutritious foods back into my diet in less-than-healthy quantities. Part of that I wish I could blame on my mom’s menu preferences, but really, I don’t have to eat jelly beans, chocolate candy and cookies with her. I don’t have to eat fast-food burgers and fries or frozen lasagnas. (She can, does and always has eaten all of those things with abandon without gaining any weight or exhibiting any other noticeable side-effects. Grrrr…) The hard truth is that I know how to eat mindfully—I just have to do it.

Starting a fitness regimen a month ago at the gym was a step in the right direction (and one that has fallen by the wayside during the last couple of weeks, thanks to some increased pain and disability, and then some other, sort-of-overwhelming events). Still, I’d like to think the increased exercise had nothing permanent to do with my present RA and bursitis pain; that instead, starting it up again can only help. Now I need to revamp my diet and drop the extra 20 pounds I re-gained. The weight is probably a factor in my present condition, too. Excess strain on the joints, inadequate nutrition, more sugar than is smart or healthy …

It’s a challenge, keeping things in balance with this disease and the other conditions it spawns over time. And it’s one that will never really end, so part of being successful in meeting that challenge has to be accepting it. I’m working on it, trying hard to keep the dread away. I guess that’s all any of us can do.

General springishness

Ornamental cherry tree

Spring snuck into the northern California foothills about three weeks ago. (Yes. It was only February, probably the coldest, harshest month of winter in the rest of the Northern Hemisphere.) It was 68 degrees out and sunny. Today, everywhere you look there are ornamental fruit trees in full bloom—glorious, rounded clouds of pink or white—and there are daffodils showing off their sunny yellow faces in lawns and gardens everywhere. Here and there, tucked into quiet corners and unexpected spots, there are tiny crocuses in a rainbow of pastels. And many of the deciduous trees have already put on their fine, yellow-green sheaths of perfect, unfurling new leaves.

Spring is pretty, I’ll give it that.

Western redbud in bloom.
Manzanita blooms.

On the mostly-still-wild, chaparral-covered hillsides that surround and permeate this foothill community, the redbud shrubs and the manzanitas are fixing to bloom. Soon, the redbuds will be dressed in showy suits of startling, smile-inducing purply-pink; the tough manzanitas will be covered in tiny, pinkish-white blooms that look like upside-down faerie cups. It’s the only time of the year (in my humble opinion) that this tinder-dry chaparral comes close to pretty.

The squirrels are playing tag in the live-oaks and yesterday, I heard birds singing—something I haven’t heard since leaving my mountain home 18 months or so ago.

So. Accept it, Wren. Spring is extra-early this year—and that means an extra-extra-early summer heating up, with malevolent glee, in the wings. But just as I wrapped my head around that fact, this region’s version of winter decided to make a brief comeback.

The first rainstorm arrives tomorrow, followed by two or three more throughout the coming week. Rain! Wind! Sorta-cold temperatures! Yay!!

Like the rest of the country, we’ve had a strangely mild, scary-dry winter season. Except for higher up in the mountains, winters in this part of California are always mild, though, so this wasn’t really a surprise. Still, in a normal rainy season (which starts in late December and lasts, usually, until mid-March) we usually get a decent (read minimal, barely enough) amount of rainfall. The temperature becomes cool in the daytime and cold overnight. Winter here often means frost in the mornings. While parkas and heavy wool overcoats overdo it to the extreme, the northern California valley/foothill winter is perfect for sweaters, cardigans and trench coats (with liners for the cold-blooded). An umbrella is occasionally handy, but not vital.

This winter it’s been almost uniformly warmish. Daytime temps have rarely gone below 55 degrees. There’s been so little rain that the snowpack in the mountains, which the entire state depends upon for water, are at 40 percent of normal. We’ve needed no warm clothing this year. (Except for my mother, who emerged from the womb chilly and hollering for a sweater. She bundles up anytime the temperature drops under 75 degrees Fahrenheit. Indoors, with the thermostat on the heat pump set to a thrifty 68, she dresses in several layers and wraps up in an electrically heated throw whenever she sits down. In contrast, since moving down to the valley foothills to live with her, I wear T-shirts and jeans, no socks, and keep a sturdy Japanese hand-fan near at all times. We are very different. Sometimes I wonder if I’m actually related.)

Last night, the local weatherguy warned us of these imminent, incoming,

Rain settles in over valley in northern California (or, as southern Californians might say, "NoCal").

wonderfully winter-ish storms. He could hardly hide his glee. You can’t blame him: imagine how truly boring it would be to be a meteorologist in California, where the forecast for all but a few weeks of the year is for sunshine, clear skies, mild temperatures and a steady barometer reading on the high end? Where even fluffy white cumulous clouds rarely make an appearance? Where a windy day rates a Severe Weather Warning?

Well, I didn’t need Dandy Dave to tell me the weather was changing. I’d already been aching furiously all day. Both hands were screeching at me. And my bursitis hips were much worse than usual. Sheesh. Who needs a TV weather prognosticator when your own body acts as your personal Early Warning System?

The Storms are approaching with molasses-like slowness. The first, as I write this, is just now touching the far, northwest corner of the state, roughly 350 miles from here. The actual rainfall is expected to be fairly light and won’t start until sometime tomorrow. But ahead of the storm is some cloudiness—a bit of that is here already, tempering the brightness of the sun, and it’s 10-degrees cooler than yesterday. A light, fresh breeze is whispering. (Wind, my mother would call it. She’d call it a gale but won’t because she knows I’d laugh at her.)

And the point of this post? I felt like writing but didn’t have anything much new to write about. Why not the weather? Why not write about the promise of rain—a weather phenomena I love, personally, but that we’re also in desperate need of if we want to flush toilets or water flower beds once summer arrives in, like, April. My mental health needs this weather. I’ve missed two winters at

A Stellar's jay checks out the snow-covered persimmons after a late December snow at my home in the Sierras.

home, now—and anyone who has read this blog for long knows how I love the snow, my woodstove and hot, homemade soup.

In other news, Mom’s pacer incision is healing nicely. She’s still tiring easily, but the cardiologist told us to expect that until she recovers completely from the surgery and her body gets used to the pacemaker. Her mysterious, phantom bladder infection symptoms and general malaise have totally gone. Her appetite is improving—this morning, she’s already had a sweet roll, two slices of toast with butter, two chicken legs and she just wandered back upstairs with a couple of cookies to eat with her coffee. Her usually diet between early morning and noon consists of a cup of coffee and a sweet roll.

Big difference, and a positive one. She’s doing well.

And me? I’m waiting for those storms.

The good news, bad news blues

The good news: Mom’s bladder infection hasn’t heated up again. In fact, the infection is totally gone.

The bad news: The doc had no idea what caused her symptoms yesterday. No idea why she spent most of the day feeling so bloody rotten.

The good news: She’s feeling pretty good again this morning. Up with the sun and ahead of me, she fed the cats (well, she fed Mouse, who is always ravenous and not even a little finicky about her food as long as she gets a generous bowlful), got her newspaper, made herself some raisin toast, made coffee and took it all back upstairs to enjoy it. Mom loves having her first cup of coffee each morning in bed while she peruses the paper. The crackly, random sound of newspaper pages turning in the still, coffee-scented morning air is one I’ve heard for as long as I can remember, going way back to babyhood. I’ve alwaysd associate it with safety, warmth and serenity. Makes me want to pour a bowl of Captain Crunch and turn on cartoons.

The bad news: I woke up with deep, fundamental, aching pain in both hip joints and down the outsides of my thighs. My first lucid thoughts involved glum acceptance of the pain and the mundane hope for the temporary, partial relief associated with swallowing a dose of pain medication.

Here’s a question: Do narcotic analgesics make you feel high while they chase your pain off to the far edge of town? They used to have that effect on me, but that was years ago. I no longer experience that floating, grin-worthy “high.” There’s no associated euphoria. Today narcotic pain pills merely move the pain back several yards so I can get on with things a little more easily.

Of course, that’s no small accomplishment. I’m deeply grateful for the relief from pain they offer, even if it’s not as dramatic and enjoyable as it used to be. But sometimes I do miss that sweet, gentle high. It was the only good thing about a bad flare.

I left Mom’s doctor’s office yesterday evening dissatisfied, still worried about her and more than a little baffled. Like most Americans, I’ve been conditioned to expect immediate results when I seek medical care for myself or my loved ones. I expect a solid diagnosis and medications or procedures that will make the problem go away, hopefully forever. And that’s in spite of knowing—first-hand, thanks to 25 years of rheumatoid arthritis—that modern medicine, as miraculous as it can be, doesn’t always have answers and an instant cure.

So this morning, while I’m pleased that Mom is feeling better again, I’m also a little bit blue. Her pacer-stimulated heart and resulting well-oxygenated brain haven’t improved her memory or cleared up her frequent confusion—at least, not so far. And it may never do so. I have to admit I was hoping it might, because as long as she remains forgetful and scattered, I can’t go home. I can’t leave her alone for more than 12 hours at a time.

And while I’m so glad I can be here to care for her, chase away her loneliness and keep her safe, I do miss my own home. I miss Mr Wren and my daughter and her fiance’. I miss my dog, Finny McCool. I long for my gardens, the sharp, chill mountain air, the sea-sound the breeze makes rustling in the tall pines, the morning songbirds and raucous cries of the Stellar’s jays, the quick little wrens in the hedgerow and the graceful Japanese maple outside the kitchen window. I miss the quiet. I miss the colors …

For now, my home remains just out of reach, except for short visits.

Of course we’ve talked about other options. But Mom won’t move up to my house or to my sister’s house in New Mexico. Both locations are far too cold for her; she’d be miserable. And anyway, her townhouse has lost so much of its value in the crashed economy that she’d have to pay more to sell it than she’d get back from the sale—assuming it would sell at all. An assisted-living situation would probably work well for her, but such places are stunningly expensive—and she refuses to consider it right now, anyway, since she feels she’s perfectly capable of living on her own. (heh) And frankly, she’s too bright, too healthy and too independent to justify the horrible, living burial of a nursing home.

And there’s the fact that I’m able to stay here with her. She needs me. She’s my mom.

I’ll be fine. This blue funk will pass. The pain pill is starting to work, so I’m thinking about running some errands, going for an hour to the gym, and maybe even going to spend half a day at my aunt and uncle’s house, rustling up a couple of weekend meals for them. As long as Mom still feels okay, I can go out for a while without worry.

I’m thinking the change of scenery, even if it’s temporary, will do me a lot of good.

 

 

All is well …

It’s been a bit hectic around here lately, which is why I haven’t posted anything to RheumaBlog for more than a week.

At 5:00 a.m. a week ago today, Mom woke me out of a sound sleep to ask me to go downstairs and get her sciatica pain medicine.

“Aw,” I said, “sure I will. Is your hip really bad?” I was a little surprised, as she’s been doing great, sciatica-wise, for quite a while, now.

“No … my chest hurts pretty bad,” she said. Now that I was awake–though I hadn’t turned a light on, yet–the weakness of her voice registered in my sleepy brain. So did the fact that she was gasping for breath.

“Mom? Your chest hurts? How long has it been like that?” I took her arm and walked her back into her bedroom.

“Oh,” she gasped, “I guess since around 1.”

I found the lamp on the nightstand and turned it on. “You’ve been having chest pains for four hours? Mom, why didn’t you wake me??” I was aghast.

“I thought it would go away,” she said. With the light on, I could see that her color wasn’t good. She looked small, frail and very, very frightened.

I called an ambulance.

***

Mom wasn’t having and didn’t have a heart attack. It turned out that she was once again experiencing bradycardia, a condition in which the heart beats much more slowly than it should. Where a normal heart rate is in the 60 beat-per-minute range, when they measured it in the hospital emergency department, Mom’s had dropped to 29 bpm. That was why her chest felt tight, heavy and painful. It was what was causing her to gasp for oxygen. It was even why she’d waited so long to wake me–her brain was sluggish, foggy. She could barely think, let alone make vital decisions. That she was finally able to–and find the strength to get out of bed and make her way to the guest room, where I was snoozing blithely away like a hibernating bear–is nothing short of a miracle.

I could have wakened at my normal 6:30 a.m., got up and made coffee, fed the cats, got the newspaper off the driveway, performed morning ablutions and only then, when the fact that she still wasn’t up (which would be unusual, as she rarely sleeps past 7 a.m.), would I have discovered the danger she was in. In fact, it would have probably been too late.

***

In the ED, the doctors got her heart rate up to the low-to-mid-40s. Her chest pain disappeared and, with an oxygen lead in her nostrils, she started breathing more easily. The diagnosis of a second-degree heart block–a condition that affects the electrical charge in the heart that causes it to beat–was made by the on-call cardiologist. Because she was fighting off an existing bladder infection, he admitted her to the ICU and put her on IV antibiotics, hoping to knock it out quickly. The plan was to fit her with an internal pacemaker the following morning.

The device, he explained, would stimulate her heart to beat faster anytime it dropped below 60 bpm.

She still had the bladder infection the next morning, but the cardiologist didn’t want to wait any longer. They placed the pacer. Two hours later she was wide awake, smiling, bright-eyed and a little bewildered at all the hullabaloo. She felt great, except her upper left chest and shoulder were pretty sore from the minor surgery.

Phew.

A few hours later I picked my sister up at the airport. She’d decided to come (she lives in New Mexico) for the obvious reasons–but also to give me some moral support and a chance to rest, bless her heart. Mom was released from the hospital on Saturday afternoon.

She’s doing incredibly well. Her mind is more clear, more sharp, than it’s been in a year, at least. At 80, even a minor surgery takes a little time to recover from, but she feels well. The docs told her to take it easy for two weeks, and she’s behaving herself nicely, taking their instructions to heart. And while she’s still on antibiotics for that persistent bladder infection, the immediate danger she was in is gone.

My sister flew back to Santa Fe on Tuesday afternoon. I spent the day yesterday at my aunt and uncle’s house, as usual, and am doing the same today. Mom is feeling really good.

And me? Same ol’, same ol’. Hips and hands are achy, but nothing I don’t get along with every day anyway. I haven’t had the wherewithal (or energy) to get to the gym since all this started, but I hope to re-start the regimen within another day or so.

And I tell myself: All will be well, and all will be well …

Update: It appears that mom’s very stubborn bladder infection has taken a turn for the worse. She ran out of steam mid-morning and has been in bed since. As you might imagine, she’s severely bummed. And me? I’m working hard at cheerful and upbeat. Sigh …

We’re off to see her PCP in a few minutes.