A Trip to the ER

As our LAN line and cell phones rang one after the other last night, we figured something big must be up. And it was. KS called Tracy at 7 p.m. to let her know that Blanche had tripped and fallen after dinner. She hit her head and her knee and as a precaution, KS called the ambulance and had them take her to Waterbury Hospital. The emergency room. On a Sunday night. In the pouring rain. Did I mention on a Sunday night? In the pouring rain?

So we sat with Blanche for about five hours. She was in great spirits. She kept saying how happy she was to see us and how nice it was that we could all be together. She had x-rays taken on her knee and a CAT Scan on her head. It was all good. There was nothing wrong with her. But yikes, it was a long wait. Toward the end, Blanche really wanted to leave, so she started to methodically fold the blankets and sheets that were covering her. It was quite interesting to see the level of concentration she exhibited as she folded first the top blanket, which she then placed at the end of the bed and then the second blanket was folded, and also placed on top of the first blanket.

By then she was down to just a sheet covering her. Tracy kept telling her to leave the sheet alone because all she had on under it was a johnny coat. So she would stop for literally one minute, then pick up the sheet, defiantly stare at Tracy and start to fold it again! It was fascinating to watch. Tracy finally just got up, and unfolded both blankets and placed them back over Blanche so she had to start all over again. At least that bought us time so she wouldn't be just lying there practically naked waiting for the doctor. And it was freezing in the room she was in.

We watched several sets of people come and go. As each one would leave, Blanche would make a comment loud enough for all to hear. She was very nosy. It was also interesting to see her out of her normal surroundings. While she was in good spirits, she literally could not complete a sentence, which was really frustrating to her. She kept telling Tracy she had something to tell her, but she couldn't remember what it was. Tracy told her where she was and why she was there, but she did not respond to that at all.

Interestingly, when we first got there, a nurse came up to Tracy and said that Blanche seemed very confused. Tracy explained that Blanche has Alzheimer's and the nurse said he knew that!? Okay, then, why was he surprised she seemed confused? We couldn't quite figure that one out.

When the doctor finally came, he asked Tracy if in her opinion, her mom was acting normal. Tracy said, "absolutely" and the doctor was satisfied between that answer and the CAT Scan results that she had not suffered a head injury.

So, we were curious as to what would have happened if KS had not been able to reach Tracy. Apparently, the ambulance would have taken Blanche back to KS, so that's good to know.

Hopefully, it won't happen again anytime soon.

Trying to Make Sense of It

I just got off the phone with my dad's geriatric doctor. I figured if I write down all my thoughts right now, chances are that I would remember more of the conversation. She said it is her feeling, and that of the consulting doctor, that my dad's lack of motivation is being caused by his dementia and not his depression. I can understand that, but it doesn't change my opinion about the need to increase his depression medication.

I told her that I understood her reasoning. However, given that my dad cannot take Aricept because of his past bleeding ulcer issues, and they won't give him Numenda because that's only prescribed in cases of severe dementia (that's correct - that's what she said), I think that a slight increase in his depression medicine might give him some added motivation and wouldn't it be worth a try?

Ruling out Aricept and Numenda rules out the popular Alzheimer's/dementia medication that I'm aware exist. In fact, Tracy's mom is on both of those and I don't consider her dementia to be severe. Maybe I just don't know enough yet about the illness or even the differences between Alzheimer's and dementia.

If I compare Blanche's behavior to my dad's, it's hard for me to see the similarities. Blanche has bouts of paranoia, she makes things up, and she forgets everything a minute after it happens. My dad has not exhibited any paranoia, but he does seem to forget everything a minute after it happens. He does make things up, but not in the same way Blanche does. She tells us of visits she's had recently with her husband, who has been dead for six years. My dad just seems to think he's doing things like he used to do. It's very confusing, but I guess if I re-examine what I just wrote, my dad and Blanche do exhibit similar behavior...

Well, as I was writing, the doctor called back. Hard to believe! She actually gave me a referral to an experimental study that is ongoing at Yale University's Department of Psychiatry. It's an Alzheimer's/dementia study. I think it might be the same study that Tracy and her grandmother participated in when her grandmother was about 95 years old in 2004 or 2005. If I remember correctly, they went to Yale periodically and participated in testing. There were some instances where Tracy's grandmother actually tested better than Tracy did! I better check with her on that to make sure I'm not making that up!

And she then said that if we choose not to participate in the study, or if we do participate and it doesn't seem to help, then they'll bump up the depression medication! After all that. She also said if they do bump it up and it doesn't seem to make a difference, they can always reduce it. That seems to make sense to me, but I still don't get what harm there is in bumping it up now. I think I want to believe the increased medication will help, when I'm hearing these doctors say it won't because my dad is like he is because of the dementia, not the depression. I think we still have to try.

So, we're going to see my dad's primary care doctor tomorrow. I'll do some research on this study at Yale before then and see if I think we can do it. Then I may just tell the doctor tomorrow to tell the geriatric doctor that we want to go ahead and increase the depression medication.