Thank You So Much, Annie

Annie went home this morning. Her help and her friendship were a Godsend, and we know that you also appreciate the time she was able to spend with us. Let's have a standing ovation for Ms. Anna Maria!!

V was a little tough for Annie to keep in line. V sometimes wanted to do more than she should. That's how V is and that was frustrating for Annie (and for V). Annie was very good about keeping V on her meds. She also was there whenever V crashed from doing too much.

Thank you Anna Maria. We really appreciate you being here for us. More than you know!!

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Today is Jim and Venita's 3rd wedding anniversary. V went to see Jim at lunchtime and stayed 3 1/2 hours. Jim was in the dining room when V arrived, and she looked in on him though the window between the hall and dining room. A sudden huge smile on his face! V loves to see Jim respond so positively to her.

Jim is getting less confused. His confusion is called encephalopathy and results from increased blood levels of ammonia, a toxin that his ailing liver is unable to process. He is being treated with Lactulose, a powerful laxative that acidifies the stool and thereby traps ammonia and drags it out of the body along with other fecal material. The goal is for Jim to have 2-4 loose bowel movements a day. Jim eventually will be on a maintenance dosage of Lactulose, with a goal of 1-2 loose bowel movements per day.

The problem is that Jim is not having loose stools; he is having explosive, unexpected, watery stools. (Yes, it's tough sharing these kinds of details with whomever cares to read them on the Internet. But this is one way for us to vent and a way for us to help others understand.)

V has spoken with a number of folks in the Shipley SNF management, and Jim's care is getting better. They understand the embarrasment and distress that Jim is having over the poop problem, and are working at getting the floor staff more on board with dealing with Jim with sensitivity. They also are trying to anticipate the timing of the explosions vis-a-vis giving Lactulose/eating food/Jim's activity schedule so that Jim as close to the bathroom and not in the middle of something else important (like PT or a meal) when the problem occurs. The management also seems to now understand the importance of communicating with V about Jim's status. V is the alpha female and bitch Mama for Jim, and someone has to deal with V if they are hurting or not helping Jim.

Next week Venita has a "care plan" meeting with the Shipley SNF management about Jim.

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As for Venita (this is a blog about her breast cancer, isn't it?), she has been feeling good under Annie's care. V wanted to wean from pain medicines, so she took nothing this morning. Big time pain set in when she was visiting with Jim, so she's now back on Percocet. She has a post-surgical appointment tomorrow with Dr. Cutter, the breast surgeon. A friend, Ellen, will be driving her there. V has a drain, but unfortunately, it has not slowed enough for it to be pulled tomorrow.

V also has a post-surgical appointment next Monday with Dr. Boob. Fingers and toes crossed that the drain goes then.

At discharge on Saturday, Dr. Boob said everything looks OK with him to start radiation therapy on the right side. If Dr. Cutter also is OK, V will call to set up the intake appointment for radiation.