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The Elder Care Blues: Waking Up Dead

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The cataract surgery did not go well. Even though it ranks as one of the safest and simplest of surgeries, and even though the literature reports that 95.5 percent of those operated on achieved 20/40 uncorrected vision or better outcomes following cataract surgery, here -- in this neck of the elder care woods -- near two weeks have come and gone, and mom's sight is still compromised. Actually, it's worse than ever.

Mom's surgeon, Dr. C., left for Italy two days after the procedure. We were instructed, should we have any problems, to head on over to the clinic and see her associate, Dr. N.

I say, "Let's go."

But Harriet, as the saying goes, fights me tooth n' nail.

She fights me not because she is your stereotypical obstinate, inflexible 95 year old who is desperately trying to stay in control of her life. Harriet fights me because she is prone to anxiety, and the thought of getting into a taxi -- even for the shortest of rides -- is met with great trepidation.

Panic attacks are said to be one of the most intensely frightening, upsetting and uncomfortable of experiences. Often the person suffering reports a fear or sense of dying. They might feel faint or be nauseated. They might experience heart palpitations, chest pains, hot flashes, cold flashes, and dizziness. Numbness filters throughout the body. They fear losing control of themselves.

Panic attacks are not necessarily indicative of a mental disorder, but they are often linked to anxiety disorders and other psychological conditions. Harriet has not been formally diagnosed as having any kind of mental disorder, as she is too panicked to get in a car to visit a psychiatrist.

I share this information with you not to air the family pathology, but rather in an effort for you to fully understand just how difficult it is to move my mother from a foot-stomping, fear-driven "No, I am not going," into a taxi.

She is adamant, and she tells me that her gaggles of sidewalk doctor friends, with whom she lunches with daily at the assisted living residence, are positive that her lack of healing is par for the course and that her eye will clear up all on its own.

They think, and she agrees, that I should just stop "torturing" her.

As the caretaker, it is my responsibly to make sure that mom is getting the best care possible, and -- in this case -- it feels that her sight or lack thereof is also my responsibility. Period. End of report.

And, so, I persist. And finally insist.

I weigh the anxiety and the mental anguish that this 13-minute cab ride will surely produce vs. her sight. Her sight wins by a mile (actually, according to Google maps, 2.8 miles door to door).

After a thorough examination, Dr. N. (so cute and so sweet -- he should star in Grey's Anatomy) tells us that there is fluid behind the cornea, and it is inflamed.

And -- unrelated bonus (yippee, yikes and yowser) -- he notes that there are some mysterious bits of blood floating behind both eyes. Until the fluid in the right eye and the cataract still to be removed from her left eye are taken care of, he can't determine the cause of the floating blood.

We shelve the floating blood for another time.

For now, Dr. N. prescribes a new set of drops. The first to be administered two times daily; the second, four times daily; and the last, six to eight times daily.

As Harriet can't read the labels on the bottles, we create an ingenious way to keep it straight, or so I think. (I am so the eternal optimist.)

Each eye drop bottle is assigned its own bowl and in the bowl, alongside the bottle, sits a rather large color-coded sign with the numbers two, four, and six written on them respectively.

In addition, next to each bowl is a simple chart, allowing Harriet to cross off the drops as she administers them. Harriet has no difficulty physically applying the drops. She demonstrated this to both the doctor and to me as she pulled the bottom lid out, the upper lid up with one hand and squeezed the drop in with the other. Beautiful!

But, as the day grows long mom's brain grows tired, and she can't seem to sort through the sequence.

When not physically there, I do my best to call and check in every few hours. This is a good thing, or rather a useful thing to do for obvious reasons.

Harriet tells me via phone, "If you can give yourself drops from the bowls numbered two, four and six first thing in the morning -- one minute apart -- why not do them all at once? Why not just wait the one minute between drops? Within 12 minutes, I can be done with it for the entire day.

"It's more efficient," she insists.

This past week, as Harriet sleeps, she dreams about feeding her babies every two to four hours. My father is there, too, in bed with her feeding the babies. Mom loves these dreams, and I find them fascinating -- even better, useful.

She has brilliantly supplied me with a metaphor that illustrates why the drops need to be spaced apart by hours, not minutes.

I explain, "You can't feed your babies all their food in one fell swoop, can you?" (Was that why I was a fat baby? Did she feed me a day's worth of food in the morning and then, perhaps confused from lack of sleep, number of ounces and the hourly schedule, feed me six bottles, four times daily?)

On the positive side, Dr. N. was hopeful that the new sets of drops will help to release the fluid and reduce the inflammation behind the cornea, but if not, this is "probably fixable." It could take weeks or even months for this to sort out. And, he assured us that should Harriet administer too many drops or even too few, as long as it was close enough, we'd be okay.

I do my best to keep things in perspective, acknowledging that Harriet is not in pain, that we are not talking about a major illness here -- no heart problems, no cancer -- so much to be grateful for at 95. But even this -- a simple cataract operation -- is unbelievably stressful and complicated.

I realize that I can't control much if any of this, but I want answers, so I quiz Dr. N. to death.

"Is there was any chance that her eye might explode? Or implode? Might the retina detach? Can she go blind? Will something awful happen when I am unavailable, unreachable, working, at a movie or -- heaven forbid -- away on a trip?"

Dr. N. replies, "Not any more than any other time ... at this point ... in time."

There is a subtext to his words. I interpret them to mean that the advanced stages of "wear and tear" are in progress. How long this stage might last is anyone's guess, but with certainty, we are not built to last indefinitely.

On the return taxi ride back to mom's digs she says, "Wouldn't it be just wonderful if I woke up dead?"

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