Saturday, 23 July 2016

Weekends at home

Because of the way TV programming is organised, weekends at home are more challenging than weekdays. On weekdays there is a whole newsroom full of staff at the ABC producing the programming for ABC News 24 - the 24-hour TV news station of the public broadcaster - but on weekends they function on a reduced staff so they fill the remainder of the time available with reruns from the past week. Which is not as fun as wall-to-wall news. What do they think, that the news stops on weekends? People stop getting into trouble and having car crashes? What is it about weekends that makes the TV so boring?

I went up the road to have a bowl of ramen for lunch after sleeping for most of the morning. The ramen was good but when I get home I want to sit down with the TV on and drink wine and watch social media. That's what I do in the afternoons. It's like a ritual for me now - the TV on in the background with the browser windows open at Facebook, Twitter and TweetDeck, Google Plus and LinkedIn etcetera. There are a lot of windows open at my pages.

The other problem with the TV is that the volume is really low. Even when I turn the volume up to 100% it's still low because it needs to be fixed. I can't take the TV to the repair shop however because it's too heavy for one person to carry. So I have to buy a new one. Maybe when things have settled following the death of my mother I can think about spending a bit of cash on a new TV. Right now is not a good time.

The other thing that has happened is that the death certificate came through from the Registrar of Births, Deaths and Marriages. This means that my lawyer can get on with the job of getting probate for my mother's will. One of the big ticket items that has to be looked after when someone dies. In the meantime I will sit here and watch TV and drink wine. Some people have very thoughtfully offered to do something together in this period of mourning, but I find it all a bit challenging. Going out, I mean. It's so much simpler to just stay at home and engage on social media like the mad thing that I am.

Monday, 18 July 2016

Still in a holding pattern ... but improving

Here I am with ABC News 24 on in the background looking after my social media accounts. My usual situation in the afternoons. It's where I go to get away from things, helped by a bottle or two of chardonnay. You can see Malcolm Turnbull here giving his press conference on the occasion of the announcement of the government's new ministry. Malcolm couldn't make it over to my place this afternoon because of prior engagements, so I had to do with watching him on TV. I'm so amusing.

It has been a week since mum's funeral. When I look back on the funeral it seems like such a little thing to celebrate - is that the best word? - an entire life. Perhaps more fittingly I have been going back over my blogposts - which started on the subject of mum in November 2014 - to read them anew. What I find is something full of life and tenderness. I am touched by the bigness that small details occupied in my life on the subject of mum. Little things like making lunch at the right time so that we could always have dinner at the same time in the evenings.

Of course it was when I was living with mum up on the Coast that I started to drink wine in the late afternoons, and on into the evenings. I would rock on over to mum's place at around 4pm or 4.30pm in readiness for preparing the evening meal. I remember what I cooked, too. There were the favourites like chicken wings roasted in the oven. Steak, mashed potatoes and boiled vegetables (the zucchini put on last because it didn't take as long to cook as the carrots). Or a nice roast beef with roast potatoes and pumpkin, served up with gravy made from the juices left in the baking tray.

I would drink while preparing the meal and while eating it too, then I would put a bottle of wine in the bag I had brought for the purpose, and carry it home to drink further into the evening, as I sat in front of the computer with the TV on in the background. Watching TV obliquely with social media to the fore, and with wine to accompany the mix, has become something of a habit.

And I remember those day trips down to Brisbane on the motorway from the Coast. About 2 hours driving outside rush hour, just a quick jaunt to the gallery to have a look at what was on in the art world. Two galleries in fact, since they built MOMA next door the the state gallery. And a sandwich for lunch at the cafe outside the state library.

Today I walked up to the post office to pick up the box of coffee that they had tried to deliver earlier on in the day. Somehow I had missed the buzzer on the front door. Sleeping probably. When I wake up in the mornings the day seems so lifeless and blank. I don't know what to do with myself, so I go back to bed to snooze through the morning if I can. If I cannot then I get up and switch on the TV and go back to social media and wait until it's lunchtime.

Wednesday, 13 July 2016

Returning a wedding ring to the nursing home

The first time mum went into hospital in Sydney I took off her wedding ring and put it in my pocket because there were signs up in the hospital about protecting valuables. I took it home and put it in a drawer in my bedroom. But when mum had been sent back to the nursing home and I had gone up to visit her again I noticed that she was again wearing a wedding ring. I asked her about it and she said it was hers. I took it off her hand and gave it to the staff. However another wedding ring appeared in due course and so eventually I gave up trying to wean mum off the habit of wearing them.

I never worked out where she got the wedding rings from. Had she got up in the middle of the night and wandered into someone else's room? Had someone given her the new rings? Was she swapping them for something else of value? The puzzle remains a puzzle to this day. I asked the staff about it again today when I took this final wedding ring - which the funeral directors had taken off mum's hand after her death - back to the nursing home but they didn't know the answer either. Some things can never be known, like what old people do with their jewellery in nursing homes. No doubt mum had simply looked at her hand, thought to herself that she needed a wedding ring on it, and had acquired one. Somehow.

I drove up to the nursing home this morning along the normal route. It was a leisurely drive. The car seemed to know instinctively where to go, which lanes to change into, and when to indicate to turn or change lanes. I just sat at the wheel and let things take their course, seemingly in auto-pilot. On the way back to the motorway I stopped at the Vietnamese bakery and bought a sausage roll and a pork roll. I ate them in the car, which turned out to be a bit of a risk because somehow I wiped my right eye with a finger that had touched some chili and it started to water furiously as I was driving down the Warringah Freeway. But I made it home safe in the end listening to the radio as per normal.

Later, I discovered there were some things missing from the box of photos - including an oil painting by Barbara Cameron and some old 19th century hymnals - and I phoned the nursing home to ask where they might be. They said they would get back to me in a few days.

Tuesday, 12 July 2016

Book review: Karl Ove Knausgaard, My Struggle vol. 1, A Death in the Family (2012)

When my mother was in the hospital dying recently I read to her from this book - a part of the narrative where Karl Ove and his brother are cleaning their grandmother's house following the death of their father - and, also later, when she was in the nursing home I read from the book again. On the day of mum's funeral I finished reading this volume in the series. But these things are of no material interest in themselves. I include them only for autobiographical reasons.

Knausgaard has successfully made an industry out of his own life. He has, it is said, alienated a large group of people including certain members of his own family. In the event you wonder if it was worth it. The sales of the books - five have been translated and six written - would suggest it certainly was.

And people talk about Knausgaard because his success is something of a publishing phenomenon. So everyone has their opinion about him. If he is boring, he is still compelling. That is one thing I have heard people say. For myself, I almost stopped early on with this volume in the series because I feared the incipient violence of the father - I shun violence wherever I see it - but a friend suggested that I would enjoy the book. And I did enjoy it. I especially found the modulated tone of the novel a relief. Here there are no sudden rises in the tenor of the writing to disturb you. Everything is at a steady, predictable level, and it is restful to read.

Knausgaard is a clever writer who also embellishes his prose with accurate descriptions of things as varied as the way the sky looks over a town in the summer, or the way a seatbelt is fastened to its clasp. He is not afraid of any challenge, and you feel assured that he will carry you along on the platform of his narrative in a leisurely and steady pace until you reach the end. He is nothing if not stable. Which is sort of nice as there is so much bruising writing around these days. I start a lot of books and I finish a lot fewer. Mostly only books that I finish get reviewed here.

The death in the family is the death, of course, of Karl Ove's father, and most of the story centres around Karl Ove's youth or the point in his life - much later chronologically - when he buries the man. Many young people - myself included - complained (and complain) about their fathers, of course, so the trope is not unexpected. Karl Ove is also just a little bit younger than me so his cultural references are familiar to someone of my age reading the book. So there is a lot in those early parts that is close to home. Although Karl Ove seems to maintain his love of soccer into middle age, whereas I largely abandoned any interest in sport as soon as I became an adult.

All these things are highly personal, and it is true that you do develop a personal relationship with the author/main character, Karl Ove. The way he grows on you is gradual, through the general accrual of detail that goes to make up the narrative. He grows on you bit by bit until you have formed a distinct opinion about him in your mind. You like these parts about his character but you regret that he seems to have certain failings too. But he gets under your skin. The link between the author and the reader is intimate. It's something that will stay with you for a long time. It's something that only literature can make happen. It is its own type of magic.

Monday, 11 July 2016

The day of the funeral

Someone kindly gave me a bunch of white carnations for the funeral today. I brought them home and put them in water. There were ten people attending the short service, which only took about 30 minutes, and who later came next door in the funeral home to have sandwiches and sausage rolls and small, coconut-filled cakes. There were also scones with jam and fresh cream. There were jugs of fresh juice and cups for coffee.

Two people stood up to give an account of their memories of mum - myself and G, mum's housekeeper - and there were also some words from mum's niece who is currently on the road with her family crossing central Australia in a car. I spoke extempore, without notes, as did G. Clare's words were spoken by the civil celebrant, Charyl.

My contribution was basically a brief biography. I remember I was looking down at the lectern all the while I was talking. I felt more comfortable talking this way, rather than looking up at the collection of people in the room. I was a bit worried about suddenly tearing up with emotion if I caught someone's eye, so I just kept my eyes lowered during the whole of the delivery, which took about ten minutes. G told me she started to get nervous during her presentation. In fact she did very well. She said later that I could be heard quite clearly while I was talking.

After the service - during which we watched a short photo montage of images taken from my collection of photos of mum - everyone gathered outside where the casket by this time stood in the hearse. We said our last goodbyes. Clare's mother, mum's sister-in-law, guided me to the coffin and I started to get emotional. I touched the cold, varnished wood, which was a mid-brown colour, and I could see the condensation from my warm hands forming on its surface. I took back my hand and turned away from the coffin. The hearse started to move off after they had closed the swing door and moved slowly around toward to cemetery, which is located just down the road. The cremation will probably have already happened by now, or if not yet, then soon.

We all gathered in the room next to the chapel where the food was laid out. We stood around in small groups talking. The staffer in charge of the event came and spoke to me briefly about future things - including the death certificate, which he says will take the government about two weeks to produce - and then he left to attend to other things. I asked for containers to put excess food into. We had originally planned for about 20 people so there were a lot of uneaten scones by the end of the morning. Someone brought plastic containers into the room and left them near the hot-water urn. I picked them up and started to load them with sandwiches and cakes using the tongs that were scattered around the place. Others did similarly, in preparation for taking home some simple refreshments. Later, we drove down the motorway and I dropped off two friends in the city who had arrived at the event by train. Then G and I drove home through Chinatown.

When I got home I opened up the box containing the visitor's book and in it was the death certificate that was filled out by mum's GP after her death. It said that mum had died from cardiovascular collapse which had proceeded for minutes before life expired. So she had finally died of a heart attack related to the sepsis.

Saturday, 9 July 2016

Feeling rather strange since mum has gone

This morning I woke up and made some coffee, then drank a cup and went back to bed hoping to resume the dreams that always punctuate my sleep, but no luck, the dreams had fled. The coffee maybe had chased them away. I tossed and turned for a couple of hours until I got fed up with it and emerged. In front of the computer I went through my Facebook feed for the past 12 hours or so and made some comments.

The laundry had to be done and I always love doing the laundry. I had washed the clothes in the morning while I was still in bed, and so I put a load into the dryer and switched it on. The dryer rumbled comfortably for the 45 or 50 minutes or so that it takes to do a load. During this time I had the TV on and was listening to it in the background while attending to social media. Then I took off the first load and put it in the laundry basket. I put on the second load - the shirts - and sat back again with the TV on above the tumble of the dryer. Room room room room room room room room went the dryer.

I tottered around the apartment until it was time to go to lunch and off I went to the noodle shop down the street which - I discovered today - is operated by a Korean who lived in Japan. His front-of-shop staff - the girls - are Japanese and the cooking staff at the back - the boys - are Korean. He talks to them in their own languages. He likes me because I always buy a beer at his shop on weekends to go with my gyouza and ramen.

After eating I came back and went back to bed to read some of my book. But it was boring and I got up and ironed the shirts, then went out to watch TV and drink some wine. I started to feel human again. The strange feeling I get when I am alone in the apartment - when I feel as though my head is located about a mile above my body - disappeared. I started to feel normal again. Not normal like I do when I am doing the laundry, but normal for when there is no laundry to do. Tomorrow at lunchtime I pick up G from the airport as she is coming down again for mum's funeral, which is on Monday. I'll have to find a tie to wear.

Wednesday, 6 July 2016

All alone since mum passed away

It seems strange that there's noone to drive up the motorway to visit. I used to enjoy the approach to the motorway ramp, just down the street, with the radio tuned to ABC 702 in the mornings and the talk shows emanating through the speakers. It's very strange to be able to stay inside in the mid morning instead of venturing out to go to see mum in the nursing home or in the hospital. It has only been a few days since mum passed away but already the tremors are being felt.

In loneliness. The empty hours which previously would be filled with a sense of purpose. Now they are spent wondering what to do. Waiting for the late afternoon when the wine can decorously be brought out to sip. Waiting for someone to call, to tweet, to post. Lonely hours in limbo.

I am waiting for the funeral, which will happen next Monday, to rouse me from this torpor. I will probably cry. I have met with the funeral celebrant and we have decided that I will just talk extempore for a while about mum. Mum. Her photo with me appeared on Facebook this morning. The photo we took in 2009 when I had just moved up to Queensland to look after her. Since then we have spent a lot of time together, eating dinner, watching the corny UK TV shows she loved so much in the evenings, in the nursing home, in the hospital.

Waiting for the funeral but also waiting for the rest of the process to get through, including the proving of the Will and the issuing of the death notice. All these things take so much time and consume so much erratic attention. In the meanwhile I am sitting here with a glass of chardonnay and watching TV in the background while attending to social media. A quiet, solitary place animated by other souls in their textual brackets, as it were, in their own little boxes of sense and quotation. I watch the world go by and wait for the time for dinner to arrive. It's almost like being in company, and sometimes I talk with someone. Like you. I can talk with you.

Monday, 4 July 2016

Getting the funeral organised

This morning I drove up to the nursing home to get some clothes to dress mum in for her funeral. One of the nurses there brought down one of the care staff who normally showered and dressed mum in the mornings to select some things, including underwear, a pair of pants, a shirt, a jumper and a pair of shoes. I put them into a plastic bag I had brought along for the purpose and collected mum's suitcase - which was actually my suitcase which I had used for moving her down to Sydney - and her purse from her handbag. Then I took everything out to the car.

I drove south along the motorway to North Ryde where the undertaker's office and chapel is located. (This is where I had got lost on Saturday looking for the cafe.) I gave the staffer there the bag full of photos - including a thumb drive with some scans I had made years earlier, two or three loose prints, and a framed reproduction of a black and white photo mum had had - and explained that the person I have met on Saturday had asked me to bring them in. I also gave her the bag of clothes for dressing mum.

When I was finished at the undertaker's I drove home and then went to see my psychiatrist - we have an appointment every two weeks - who listened to me complain about things for an hour. It's always a relief to talk to him, it seems to do me good. After that was finished I dropped into a nearby restaurant to have a bowl of noodles for lunch, then I went home and lay down for an hour.

The undertaker sent me an image showing what the newspaper ad for mum will look like. So far I have had about nine responses from people who want to come to the funeral, and there might be a few more as a result of the newspaper ad. Everyone has been so kind since mum died, I have had a series of big hugs from people I have met, including lovely ones from staff in the nursing home. I don't know why I worry, but I do, so there you go.

The image that accompanies this blogpost shows a detail from a rug mum knitted some years back while still in Maroochydore. Of late she would not have been able to do work with this much detail. It is made up of a series of "tracks" of native animals with embroidered captions ("croc xing", "brumby xing") making up a patchwork quilt that is very special, and I have someone in mind who might like to receive it. I'll take the quilt up to the dry cleaners when I get some free time.

Saturday, 2 July 2016

The day after mum died

I bought a democracy egg and bacon roll this morning at the polling station after voting. The queue for the voting booth even at 8.05am stretched round one corner and almost to the next. It's a busy booth, as you can guess. But I also was busy because mum died last night.

Last night I had just returned from having dinner and was in the apartment at around 6.30pm when the nursing home called. The voice on the other end was hesitant and reluctant so I knew what she was going to say before she said it but nevertheless the sobs gushed out as I answered and told them that I would not come out then but would instead visit the nursing home in the morning.

I went online and contacted my daughter and talked to her on Skype for a little while. Not long. But enough to get through that stage of grief when all you can do is sob breathlessly and helplessly from the pain. She tolerated my emotionalism stoically and I could see her lip quivering in response. It was exactly what I needed. Then I got down to making more calls to tell family members and I also made a quick Facebook post that generated a big reaction from friends and family on social media - more than I expected, and I was very humbled by the goodwill out there in the community. People had been reading my blogposts and so they were aware of what has been happening with mum.

Later in the evening I watched some mediocre British crime dramas and then went to bed where I hardly slept until early this morning, and even then it was fitfully. After getting up in the morning and voting I drove up to the nursing home and called my brother on the iPad that had been left there. I told him about all the things that have to be dealt with - from the Will to the death certificate and the funeral arrangements - and we talked a bit about the pictures that mum had in her room, which we will now deploy elsewhere.

I carried photos and paintings down to the car parked in the garage - a local soccer comp that was on in the park meant street parking was scarce when I had arrived at the nursing home - and drove to the appointment I had made at the undertaker's in North Ryde. There I parked and walked off in search of a cafe but the path just took me to a caravan park. I asked for directions and they pointed me back down the road, so I trudged back along between the forest on one side and the cemetary on the other, until I returned to my car. Then I drove up into the cemetary driveway and found the cafe, where I ordered a sausage roll and a small flat white.

Later when I had finished eating I met with the representative of the undertaker's and we went through the seemingly endless series of questions you have to answer to bury someone. There are forms to fill out and sign, some of which have to be sent off to government offices, so it's all very detailed. I could hardly imagine going through all this alone so I was glad to have the undertaker to lead me by the hand. As they say, it is a stressful time in anyone's life.

I finished up, got in the car and found the tunnel back to the city, then drove down the motorway until I arrived at home, unloaded the car and lay down to rest. I didn't sleep again. My mind is rushing with so many thoughts and worries, and now I hope that a few people will come along to the funeral which will be held at Gregory & Carr's, 14 Delhi Road (cnr Plassey Road), North Ryde on Monday 11 July at 11.30am. Just drive through the black gates on Plassey Road, there's parking inside. Drop me a line if you want to come along, as I need to get the numbers right for catering purposes.

Thursday, 30 June 2016

Mum back in the nursing home again

Mum won't leave the nursing home alive. I went up there to see her and tears started to fall when I was turning off into the road that passes by the Epping shopping centre. So many memories. A place I have driven to so many times. So many good memories.

I met mum's GP by accident at the nurse's station on the first floor after I signed in with my name. We talked. He has agreed to using palliative care at this point in time. I told him I had an appointment at the haematologist's to cancel, and he said just to call them. The haemetologist had complained about the hospital sending mum back too early last time they had done so.

Going down the hallway to mum's room I wondered what sight would greet me when I pushed open the door to her room. It is a place I have visited so many, many times in the past. I have left part of myself there due to these visits over the months. It has been 18 months since mum moved here from the Coast.

Inside her room I saw mum in bed wearing a yellow striped pajama top. On the left side of her bed they had put down a pressure mat to call the nurses when she steps on it. Under it was a soft mat. On the right side of her bed there was just a soft mat. The soft mats were blue, the pressure mat grey. She had a blanket over her body and her legs, and a bedcover over her legs. The bed was low to the ground to prevent her getting up unassisted.

I went over to the table and put down the iPad box I was carrying. I took out the iPad and called my brother. I turned the control to show him mum lying on the bed and he looked hard at the picture revealed by the electronics and the software. I closed down the conversation after a little while and put the iPad back on the table, and plugged it in at the power point. I sat down and picked up the Kindle and started to read where I had left off reading last night in bed alone. It was the story of Karl Ove in Bergen, the university town he had gone to when he had left home as a teenager.

I read for mum for about an hour then went over and kissed her. I asked her if she was ok. She had been pushing the covers down with her hands while I was reading from the Kindle and so I asked her if she wanted the bedcover taken off her legs. She said "Yes" quite clearly. You have to listen very carefully because she cannot enunciate whole words now. She is incapable of talking, poor thing.

Wednesday, 29 June 2016

Mum's last day in the hospital

This is mum smiling bravely for the camera when I took her picture in the hospital this morning. Today will be her last day in the hospital. This afternoon they are moving her back to the nursing home where she will undertake palliative care.

I arrived at around 11am as usual - the start of Ryde Hospital's visiting hours - and she was sitting in the chair next to the bed. The nurse told me that she had eaten most of her breakfast. She had eaten all the eggs and half of the porridge. Then she had tried to get out of bed so the nurse had put her in the chair next to the bed instead.

Mum was not coherent when I came. There were a few words but mostly parts of words coming from her mouth. She was obviously confused. Whether she was delirious it is hard to say because I could not really understand what she was saying. She was pulling at her gown and dragging at a sheet that emerged from underneath her as she sat in the chair. The nurse told me that she had taken her gown off a few times already this morning. I kept on going over to her and saying, "Don't take it off mum."

As I had the day before I read to her from the first book of Karl Ove Knausgaard's My Struggle series. Today it was the two men going back to the house where their father had died. Despite the grizzly details mum seemed to enjoy it. Yesterday she had been even more vocal, and answered the questions that had popped up in the narrative as part of the dialogue, happily chiming in with "No" and "Yes" as the need arose. It was sweet.

Poor little thing. She will be back in well-known surrounds by the end of the day, and so I rang the nursing home to tell them she was coming back as I had received a call from the hospital to that effect. I got onto the deputy director and had a quick word to her. She said they were happy to have mum back. They are a great team of people at the nursing home, I am so grateful that they have been taking such good care of her. It makes my life so much easier knowing that they are doing whatever they can to make sure she is comfortable and cared for. I think nursing homes are fantastic places, the staff at my own place are always so responsive to people, always trying to give good service.

Monday, 27 June 2016

Mum goes into palliative care

So today brings the sad news that mum is being placed into palliative care. In the morning I spoke with my cousin who had brought my attention to mum's AHD, after mum had been moved overnight to the Cardiac Care Unit from Ward 7. Then I came back to the hospital this afternoon after Clare had returned to the road for the trip north and I spoke with mum's attending doctor. I had also earlier spoken with another doctor - who goes around to different units to help out where needed - and he had spoken to me about mum's AHD. (He was the same doctor who had spoken to me once before in the Emergency Ward about the AHD, and had advised me to think about what it contains.)

Mum's attending doctor examined her records and came to her room to have a look at her. He tried to get her attention but was not successful. We went outside the room to talk. There were two young doctors also standing there on their training rounds. The attending doctor told me that mum was getting worse. Her heart rate had gone up to around 140 bpm and she was struggling. Even when, two days earlier, she had looked well and was responsive, she was not mobile. Her likelihood of recovery was poor and even if she did beat the infections - in the right leg and in her bladder - and get out of the hospital she would likely be readmitted shortly due to the MRSA infection in her right leg.

He asked me if he could put mum into palliative care instead of putting her through more uncomfortable procedures, and I agreed. He said "Ok" and asked me if I was alright. I said I had been looking after mum for seven years and had seen the degeneration of her health over the previous months and years. I went back into mum's room and said goodbye. The doctor came in and turned off the heart monitor and a little while later a nurse came and disconnected mum from the machines. The room was suddenly less active. It was almost quiet except for occasional footfalls in the hallway outside the room where mum lay alone apart from me, sitting there in the chair in the corner. Mum lay there with her mouth open. A nurse came in to put cream on mum's lips to prevent them cracking and causing pain. I stayed for a while then I left and drove home.

Sunday, 26 June 2016

Mum is a bit delirious

When G and I arrived in the ward today we could hear mum talking out loud - obviously disturbing the other occupants of her room - and the word that was most obvious in her monologue was "rabbits". She didn't make much sense. It was clear that she was delirious and that therefore she had slipped back a bit compared to yesterday. Yesterday she was talking normally and making perfect sense. Today she was ranting deliriously.

There was no wall between what she wanted to say and what emerged from her mouth. She would react to the slightest snippet of conversation overheard from a nearby bed. She would react with disdain to the suggestion of a mouthful of food. She would yell when the doctor picked up her arm to examine the skin on it. She was just voicing all her feelings without any barrier between the inception of the feeling and the final word that emerged. It was just not the way she normally is. It was the infection talking.

We tried to get her to eat something but without much success. We had more luck with the coffee - a flat white - which I had bought at the kiosk outside the hospital's front door. They make decent coffees there so I don't blame mum for not eating the chicken breast and pumpkin and mashed potato that the kitchen had prepared (I tried some and had no trouble eating it but it wasn't exactly cordon-bleu).

After the visiting hours had ended we left and came back home, then walked up the street to have some Vietnamese food for lunch. I had a chicken pho and G had summer rolls. Tomorrow G goes back home to the Coast.

Saturday, 25 June 2016

Mum feeling better in hospital ward

G and I went up to see mum this morning in the hospital and she was awake and talking to herself when we arrived. She speaks slightly awkwardly - the jaw doesn't seem to move unimpeded at the moment - but at least she can make herself understood. She was amenable to humour and we had a bit of a laugh as the nurses came in and out, connecting a bag of antibiotics to the cannula in her hand. There was a vitamin supplement to dissolve in water and drink as well, which we accomplished during lunchtime. The cleaner came by and mopped under the bed.

So it looks as though the difficult time of mum's recent illness has finally disappeared, which is a relief. It took a bit longer than usual to go - four days - but she is now sitting in bed with open eyes listening to what is going on around her. That's a long way from where she was even yesterday, let alone on Wednesday when she finally was admitted to the hospital. At that time her health was very touch-and-go. Now she just looks like she's just waiting for the nod from the doctor to let her leave to go back to the nursing home.

About the future, I spoke last night with mum's GP. He called while we were in the restaurant having dinner. He told me that the periods between illnesses was getting too short - ten days in hospital giving you two weeks of free time in the nursing home - and that he would prepare a letter for the nursing home staff for next time mum gets sick. Which will be soon enough, there's no doubt. When it happens the GP will be recommending nothing more than palliative care in the nursing home. This means - sadly - that mum's days are numbered.

She has done well however. Back in November 2014 when she first got the diagnosis for the myelodysplastic syndrome the haematologist gave her a prognosis of only six months. She did a lot better than that, it's clear, and has kept herself together for a bit over 18 months now. She has had a good trot overall but it's going to be time soon to put aside the tubes and the drips and let nature take its course. I'm only glad it's not my decision in that case.

Thursday, 23 June 2016

Mum is in hospital ward again

Yesterday I picked up mum's old housekeeper G from the airport. We went up to the hospital in the late afternoon - a bad time for the traffic - and saw mum but she wasn't really talking much. She was mumbling sort of incoherently and could barely answer you when you spoke to her. Today she was a bit more compos mentis and even opened her eyes at one point.

She has a bad infection and the doctors in the ward are still uncertain how she will go. It's a bit touch and go at the moment, frankly. G and I spent an hour with her this morning. We gave her half a bottle of water to drink - in a cup through a straw - and offered her some cake which we found in a packet on the tray near her bed. But she refused the cake. She looks very frail still although she is talking more than she did yesterday. We will go up again to see her tomorrow.

If anyone wants to visit mum in Ryde Hospital she is in Ward 7 out the back of the main entrance and up the ramp. She can respond to words quite well although her replies might be a bit confused. She has been very sick indeed, so you have to be a bit patient with her. Cake might not be eaten, not sure.

Tuesday, 21 June 2016

Just a quick trip up to see mum

I quickly dropped in to see mum at the nursing home today because the nurses there told me that she wasn't taking the antibiotics the hospital had given them to give to her. The antibiotics are oral type, and when I saw her with her head on her pillow, breathing deeply through her mouth, I understood the situation immediately. She is almost completely incommunicado. I talked with the RN, who told me they had been trying to get onto the GP but that since he had moved his practice, they had difficulty contacting him.

I only stayed for a little while. Mum was washed while I was there and during this procedure she uttered incomprehensible sounds that gave you the impression of displeasure. She didn't like being towel-washed. The nurses are doing for her as much as they can but it is difficult for them. They also told me they would be getting in touch with an after-hours doctor at 4pm. I called the nursing home a little while ago but they just put me on hold. They were obviously busy on the first floor with dinner. Then I called later and confirmed they would be installing a spray to keep mum's mouth moist while she is in her current state.

Tomorrow G - mum's old housekeeper - is coming to Sydney to visit. I had asked her to come down earlier. Originally she was to come down from the Coast on Friday. When I pick her up from the domestic terminal we'll go up to the nursing home on the motorway.

Monday, 20 June 2016

Another hospital visit for mum

When I got up to the nursing home to visit mum today she was like she looks in this photo: quite incommunicado. Not hearing, not responding to words. We called the ambulance. I popped downstairs to have a word with the deputy director of the nursing home. She heard me out as usual. I got from her the message that mum is getting close to the end. I went back upstairs to wait for the paramedics to arrive, and when they did I talked to them to answer their questions, then went outside with them and drove to the hospital.

I sat in the emergency area waiting room for about 45 minutes then snuck outside to the kiosk and bought a sandwich and a drink for lunch. I was hungry and the simple food they serve there was exactly what I craved. I went back in the emergency waiting room and went to the desk to ask if it was ok to go inside, and if the doctors inside had asked to talk with me.

They let me in. The nurse at the desk told me to put on a plastic apron before going into mum's enclosed room. (She is quite toxic because of the MRSA in her leg.) I sat there with the white apron over my outdoors jacket feeling a bit odd, like a cook without a stove, and talked to mum gently while she lay there. Occasionally she would say something like "My legs are cold" and I would get a new blanket for her. Mainly though she just lay there breathing with the heart machine beeping away happily.

I spoke to the young female doctor. She brought me a copy of the AHD which the nursing home had included with mum's things to go with her in the ambulance. We talked about it. Especially the part where it says that in the case of a terminal illness she is not to be given antibiotics. I told the doctor that my inclination was to give her vancomycin but that if the hospital said otherwise I wouldn't complain. Then when the doctor had left to get back to her work I called the nursing home and asked to speak to the deputy director.

The nurse I was speaking to talked to me gently and told me that I could choose for mum, but that she understood it was a terrible responsibility. She said it was an awful thing to have to decide; whether someone lived or died. But she said she understood if I wanted to end things because the vancomycin - although it is a strong antibiotic - was only a "band aid" (the exact word she used). If we gave it to mum today then in two weeks' time she could be again on her way to the hospital in an ambulance.

Then she said I had done everything possible for my mother. I had been a good son. And this made me weep. The idea that I could have got this right - this caring for mum in these awkward days I had not prepared for - made me break down and shed hot tears. I tore off the apron and headed outside to the emergency nurse's desk, and said I had to go home. The nurse however followed me out into the hallway and asked if I was ok. I told him that I thought that it was pointless to keep treating mum because she was just going to get sick again, and that we should respect the words in the AHD that mum had herself signed off on two years earlier. I told him through the tears that I had been looking after mum for seven years now. And that now I was tired of the constant worry and anxiety the sickness instilled in everyone around her.

I went out to the car and stopped off at the servo on the way home to refuel and buy a sandwich. When I got home I opened a bottle of wine and poured myself a glass. Never had wine tasted so good. I was so exhausted by the neverending worry about mum and her leg. Later, after I had eaten some dinner, the nursing home called me to tell me that mum had returned, but that she wasn't able to take the oral antibiotics the hospital had sent along with her. I called the hospital to confirm what to do and they called the nursing home. The nursing home called me back a while later and we had another conversation, the nurse and I. But I feel as though my mother is already calling from beyond the grave.

Thursday, 16 June 2016

Walk to the park with mum

In this photo taken on our way to the park mum looks happy enough but it was hard going for her, especially once we hit the grass on the way to the second bench. Mum might be grinning in the photo but she was soon muttering under her breath and groaning with the exertion required. We took about 15 minutes to get to the second bench, and then we sat there for about 25 minutes. We left not because mum was getting cold but because of the lunch to be served, and because of the time it would take to get back inside the nursing home.

On the way back to the nursing home, as we were going down the footpath alongside it, mum ran out of puff completely and I sat her down on the walker. I guided her down the footpath to the gate, then opened it and pushed the loaded walker inside. Then I went up to the entrance and found a wheelchair in a cupboard on the ground floor. I brought it outside and put mum in it, then took her inside and upstairs to the lunch area. I sat her down at a table and went to put away her outside clothes - jacket, scarf, cap and sunglasses - then put away the wheelchair downstairs and went outside to get mum's walker, which I had left near the side gate.

Mum is very frail. Actually, this will probably turn out to be her last unaided walk outside to the park. In future I will be taking her out - but from now on in the wheelchair. Getting to the bench and getting back inside is just a bit too much effort - for her, now - and so it is going to have to be me pushing mum around in a wheelchair from now on. It's just too risky for her. A fall outside at this point would be awful. I can't contemplate how unpromising it would be for her to fall when we are in the park.

But regardless, she is still going. Her right leg - the one that has given her so many problems in the past two months or so - has stayed inert. It is not inflamed and sore. So for the moment things are under control and we can hope that she will keep going indefinitely. Nevertheless it is only realistic to anticipate that the infection will return at some point in the future. The question is when. How long will there be between hospitalisations - when she will receive treatment using vancomycin (pretty much the last antibiotic that works on her)? How long will she have in the nursing home in the interim?

A couple of days ago I spoke with the nursing home's deputy director about these issues. Things that I had already spoken with mum's GP about. We agreed that we would treat mum again next time she needed hospitalisation, and then take it from there. It is the frequency of admission to hospital that is key. How much time does she get that has real quality of life in it, between stints in the hospital? We'll be looking at this as we go down the track.

Tuesday, 14 June 2016

Negative gearing is good policy

I completed a voting intentions survey from the SMH yesterday which showed that my place on the political spectrum was closest to the Greens. I thought this was a bit funny since I'm planning to vote LNP on 2 July, and I said so in the Facebook post. But a person I know asked how it could be possible for me to vote conservative, and so I explained. He wasn't very impressed to put it mildly.

But as George Megalogenis, the journalist, has written in his recent book, immigration is the underpinning of Australia's economic strength. We've been taking in a couple of hundred thousand immigrants annually since the 1950s, which is why Australia is one of the strongest economies in the world. These people all need somewhere to live, and rental accommodation will be the solution for the great majority, at least in the beginning of their residence here. Cheap rents are important therefore, otherwise we fail all these people. So we need negative gearing to help maintain the supply of new properties. The "oversupply" of new constructions of late is for example just the result of three years of strong home price growth, and if you take away the incentive to build the supply will dry up and rents will rise commensurately.

We also need to support the tens of thousands of honest mums and dads who buy investment properties to ensure a secure future for themselves in their retirement. Not only do we help the government minimise the cost of the aged pension on the Commonwealth purse, we also make it easier for individuals to have a better quality of life, and more cash to spend in their twilight years.

It always bothers me when young people who want to live in tony suburbs like Stanmore and Newtown complain about the cost of housing. I want to tell them to look further afield, where there is plenty of housing for reasonable prices. But they will have their lifestyle no matter the cost to the public more generally. The debate on negative gearing has been going on for some time so this is not my first blogpost on the subject, but I hope that it will be the last. I predict a win to Mal with a margin of 5% in July, so the debate will hopefully finally be put to bed at that time.

Sunday, 12 June 2016

Mum's bruised hands

This is how mum's hands looked after her recent hospitalisation. In fact, they've improved in this photo since she was first released from the ward. But they were so badly bruised because of the cannulas they put into her hands to accept the IV antibiotics and direct the flow into her body. A cannula is a small plastic pipe with a tube at one end and a clip at the other. The clip end faces out and the IV feed from the bag of antibiotics is fastened to it.

Because mum's skin is delicate and because she has the bad habit of taking the cannulas out of her hands when they're not connected to the IV feed, her hands become bruised like this because new sites for the cannulas have to always be found. It'll be the same story if she's readmitted to the hospital again at some point in the future. But when she got out of the hospital she forgot that she had been in hospital, and so she had to invent a reason why her hands were so badly bruised. This is how she works it out:
I don't know what's wrong with my hands. Something to do with an unrestrained horse in the back of a car with no bridle. I don't know how I got into that situation but I was in a sedan with a horse in it.
I tried to talk her around it:
It's not true you know.
Why?
You were never in a car with a horse in it.
Oh [well], it was a good story.
Finally she accepted my version but you can be sure that if I bring up the subject again tomorrow when I visit her in the nursing home she will revert to the story of the horse in the car. That's just the way dementia works. It seems strange to us, almost willfully blind, but to her it's the only realistic solution to an intractable problem: how did her hands get so banged up?

Saturday, 11 June 2016

Decisions to be made about mum's future health care

Mum and I went out to the park again today with the wheelchair. The children were playing soccer on the field and I put mum next to the second bench, and I sat on it, and we watched the kids kick the ball around the place. Some of them were quite good. After about 15 minutes we went back inside due to the cold.

I had managed to get onto my brother in Houston on the iPad this time, and I told him about mum's frail condition, and how she was prey to infections, and could be back in hospital at any time. When we had finished talking I went down the hallway to the nurse's station to ask if they could dress mum's leg as I wanted to take her outside in the wheelchair. The nurse told me that they had seen that we were talking on the iPad and so had not disturbed us when they had called earlier to dress the leg in mum's room.

While the nurse was doing the dressing another nurse came by to talk about various things that had been my preoccupation for some weeks, namely the likelihood that the nursing home would one day soon call me again to ask if mum should be readmitted to the hospital. I had also been pressingly engaged with the request that I knew would come from hospital staff - because of the advance health directive (AHD) we have in place - as to whether mum should be treated with antibiotics to cure the infection when it came. This had happened last time. It would again be my decision to make.

The nurse told me that it might be possible to put in place an alternative AHD. She also suggested having a meeting with the deputy director of the nursing home and also the GP so that we are all on the same page regarding mum's health care, when it comes to making decisions in future about it. She said she could organise this meeting for next week and asked what day I would be available. I checked my calendar and said I was pretty much free the whole week.

The reason I think it is important to have this kind of meeting is to make sure that mum's wishes - as expressed in the AHD - and common sense are adequately allowed for. Take the way the hospital has been handling mum's case since her last admission. Not only did they call me to ask if antibiotics should be used - because the AHD says not to use them for terminal illness - but to ensure that there is a degree of common sense around her treatment. In this case I like to keep in mind that the hospital kept mum in the ward for a second round of IV antibiotics because she obviously needed them, but also because the only way they could be administered when she is in the nursing home is through a pick line: a tube inserted in the arm and into the body for the fluids to enter the body through. A pick line was clearly thought to be too invasive, and so they chose the less invasive option.

Even in the best cases there are invasive treatments involved in hospital admission, including for example the catheter that is inserted in the urethra when the patient is still unconscious in the emergency ward. Then there are the cannulas - which mum is always wont to take out of her hands because she forgets what they are for when they are not plugged into a bag of antibiotics. Cannulas are like small plastic devices that accept the IV feed and direct it into the vein, but they can easily be taken out of the vein by busy fingers. The number of cannulas mum needed this time is attested to in her case by the extent of the bruising on her hands and arms. (The poor woman has devised a fantasy - she was in the back of a car with horses - to explain how the bruises came about. "The horses smelled," she said. "You couldn't make that up," she told me, looking in my eyes, as though seeking agreement.)

Poor mum. She was sitting there while I was having these detailed discussions with the nursing staff about her life. On occasion she said, "I'll just go," as though this might make the decision any easier in future. I felt terribly touched when she said "I'll just go" because I know she is saying it to avoid burdening me with any more responsibility. Not that she really wants to die. (Not that she really wants all that terribly much to live either: we talked briefly about voluntary euthanasia and how it is dealt with by the state in Australia today.) But it is a terribly hard conversation to have - the conversation we had today - because when it comes down to it you are dealing with an infection that can only be treated by antibiotics available in IV form, and that only hospitals can dispense. In mum's case therefore you come down to admitting her again and again and again to hospital, and getting her out for a week or two at a time in between. What kind of a life can that be?

Friday, 10 June 2016

Took mum to the park in a wheelchair

Up at the nursing home today I first saw mum in her room watching TV. The first thing she said to me was, "I've been in the wars," showing me her bandaged finger and the bandages on her right leg. The finger bandage is for a haematoma that has formed on the last segment of her index finger. The leg bandages are for the always-to-be-feared cellulitis, the chronic infection that keeps landing mum in hospital. I agreed that it all looked very dramatic. In my heart I was thinking furiously, assessing the likelihood of another hospital admission, wondering when the next call from nursing home staff in the early morning would come.

In the end because it was a nice enough day today, with plenty of sun, I decided that the best thing would be to get mum outside. I asked her if she wanted to go to the park. "Not really," she answered. "Is it your leg?" I asked. "I don't know, I suppose so." "Maybe we can take a wheelchair instead of walking," I suggested.

So I went out into the hallway to the nurse's station by the elevators and asked someone there if I could borrow a wheelchair. He brought around a black one but it had no footrests, so I asked if there was one with footrests. He went away and in a few minutes emerged from the hallways with this lovely blue wheelchair, which seemed just right. It had footrests and everything.

I got mum into her jacket and gave her a hat from her drawer to put on. Then as we were going out the door mum said she wanted her sunglasses. I got them from the drawer in the chest of drawers next to her bed, and gave them to her. We went down the hallway, me pushing mum who sat there in the chair. Mum felt bulky and heavy in the wheelchair and I wondered if I would be ok with it.

When we got out the front door into the open air, mum made a sound that indicated that she was a bit cold. There would be sun in the park, I thought, so I kept going. We passed the lady at the end who always has cockatoos on her railings. Today was no different and I passed by the cockatoo at a distance of about a foot; the beast had absolutely no fear of me at all. We got to the gate and I opened it with some difficulty and then we headed up the footpath. I noticed that there were no handbreaks in the model of wheelchair I was using. At the kerb we rushed down the short slope to the gutter, then I pushed up into it and we were then in the roadway.

I took the wheelchair to the second bench and parked it on the grass next to the bench, on which I sat down. I had noticed that pushing a wheelchair on grass can be a bit of a struggle, but I decided to worry about the return journey when it had to be made. We sat there making silly smalltalk, singing silly songs we invented about the sun, and commenting on the temperature. After about ten minutes of sitting there mum said she was getting cold, so we headed back the way we had come.

Back up in mum's room she headed straight for the bed and lay down, obviously tired out by the fresh air and the exertion. I took an extra wheeled walker - a blue one; mum's is red - that was in mum's room to the front desk on the first floor, and then walked back with the staffer I met, who took away the wheelchair. I said goodbye to mum and headed home down the motorway.

Thursday, 9 June 2016

Mum is back in the nursing home again

When I went up to see mum this morning she looked happy enough but was also a bit subdued. Her hands are still covered with bruises where the hospital staff put cannulas into the veins for the IV drugs she was given. Mum tried to give me an account of how these bruises occurred, which had to do with being in the back of a car with men and horses, but I told her she had been in hospital. She hadn't remembered this piece of information of course.

She went to sleep after I had been in the nursing home room for about 20 minutes, and snoozed on and off for the rest of the time I was there. I read news stories on my iPhone and caught up on my social media feeds while she slept. We had a cup of coffee delivered during my stay. The nurse also came down to see mum and I asked her to clip mum's finger nails, which was accomplished while I was there. She then took a bandage off mum's right index finger, which had been covered where a coin-sized haematoma has developed under the skin. Because of mum's blood disease she tends to come up in bruises at the slightest provocation.

Most of the time while I was with her she just snoozed away the time in her own dreams. I sat there scrolling through social media on my iPhone while watching the time. I left her alone after about an hour and drove home, bought lunch and had a nap myself. I don't know how long mum will continue in the nursing home. She showed no inclination to go for a walk - although I didn't ask her if she wanted to - and seemed just very tired. We'll have to see how she goes in the days that follow. I am planning to go up to see her again tomorrow.

Monday, 6 June 2016

Mum getting used to the hospital ward

When I went up to see mum this morning she was a bit complainey and had just been on the loo, but got into bed straight away. She was feeling cold. I told her I had been unable to come up to see her the previous day because of the inclement weather. I explained that the emergency services had been telling people to delay inessential travel, and to stay off the roads. She didn't mind. It's just that she felt a bit unwell.

Then I reminded mum gently about her claim the last time I had seen her that she was "working for the government". "Oh really?" She asked. Yes, I said, she had said that she was working for the wife of the leader of the Opposition. "Oh yes," she said today. "I have been. Her name's Margaret." Apparently Margaret had been up to see her. They had become quite good friends. "I see," I said, laughing silently and with a smile on my face. "Are you sure you're not a bit delusional?" I asked. She looked at me in a way that made me understand that she was thinking hard.

Apart from this slight hiccup mum has been ok in the ward in the hospital. Today she refused the pineapple doughnut I brought her with her coffee (she drank all the coffee) but by the time I was leaving at the end of the morning visiting hours she was busily hoeing with her fork into her lunch, which today was ravioli with mashed potato, strained pumpkin and green beans. She at least seems to have regained her appetite.

I reminded her that she would be going to go back to the nursing home soon, and asked her if she preferred it. "Oh I don't know, it's alright here," she said vaguely. "But you have your own room there," I offered. "Oh yes, there's that," she admitted. I told her she might end up in the hospital again if the infection - which they are treating as one that is untreatable by most antibiotics - comes back. "Oh well, then I'll just cark it," she said mildly. I told her that they could probably just treat her again with antibiotics the way they were doing this time. She didn't seem particularly phased by anything that might happen to her, even a sudden end of her own existence. It was as though she has become pretty much resigned to whatever fate throws at her. Which I guess is part of her dementia. I assured her that she would most likely be fine.

Saturday, 4 June 2016

Mum still in the hospital ward

Up at Ryde Hospital this morning mum was content enough but lacked some of that upbeat spark she has when she's really feeling well. Maybe it was just a bad day for her. She has been in the hospital this time for about a week but the release date has been pushed back because the doctors wanted to make sure about the infection before that step is taken. At the moment it looks like she'll be released on Tuesday but there's no absolute guarantee of this.

She seemed a bit dull to me today. I arrived at the start of the morning visiting hours and when I got there she was on the loo. When she got out she padded back to the chair next to her bed and sat down. I gave her the doughnut I had bought her and she ate the whole thing. We didn't talk much because she was not in the mood apparently - I didn't press her - but she was a bit confused, saying some things that suggested she had been delirious. "I'm working for the government," she said. "And I'm working for the wife of the person who runs the Opposition. Whose name escapes me. I'm terrible with names, I really am."

That was all she said but it was a bit strange. The last few times this week I had seen her there was nothing like this. She went to move her bowels later in the morning and when she came out of the bathroom she sat in another chair, in the corner of the ward room. She just sat there hunched over like she does sometimes in the nursing home, when she's not feeling tip-top. She came back to her bedside though when I asked her to, because I didn't want her to make the other person in the ward uncomfortable. When lunch came she ate a bit while I was sitting there. Then I went out to get something for myself to eat. When I came back she had opened the sandwich and the container of fruit, but she refused to finish her meal or touch either of these two items again. She opened the ice-cream and ate most of it, however.

I had to leave not long after she finished with her lunch, because visiting hours in the morning only go to 1pm. Overall I thought she looked a bit subdued. Not at the top of her game. She snapped at me for suggesting she eat more of her lunch, but otherwise conversation was not very lively. 

Sunday, 29 May 2016

No knowing now how long mum has to go

A nurse at the nursing home called me this morning to tell me that mum was not responsive and had not been able to get out of bed. They wanted to know if it was OK to call the ambulance and get mum taken to the hospital again. I said it was fine. They told me later in another call that mum would be taken to the Royal North Shore Hospital but this plan was changed, when I spoke with my cousin, who had phoned the nursing home herself for information. They were actually taking her to Ryde Hospital. This is the seventh time for mum to be admitted to Ryde Hospital since we moved her to Sydney 18 months ago.

My cousin had called the nursing home to find out more about the onset of the infection this time. Mum had been due to start taking a new type of oral antibiotic but the nurses had realised that mum was allergic to it. For this reason the only option was to get the hospital to bring their significantly greater resources to bear on the problem.

I arrived at the hospital later in the morning and after going into the Emergency Ward I spoke with a doctor, who discussed with me the implications of mum's advance health directive (AHD). I had gotten a copy of this document the day before and had scanned it and emailed it to my cousin, who works as a physiotherapist and often works in hospitals. The doctor talked with me about the options available and I told him that I had thought a lot about what to do if the drugs stopped working for mum. In effect, mum would be put in a ward and given palliative care to ensure her comfort, but more intrusive methods of maintaining consciousness would not be performed.

The doctor told me that I was holding up well in the circumstances, but it's been clear to me for a long time that this kind of process would be inevitable at some point in the not-too-distant future. The truth is that mum is burning the candle at both ends. Because of her blood disease (myelodysplastic syndrome) she takes medications that make it more likely that she will contract infections, so when it comes down to it you're trying to do two things that are basically incompatible, with the same body. And then there was the cellulitis in her right leg that was causing constant problems.

Today I stayed in the building as long as possible but it was getting late and I had to get home to do some chores and get ready for the next day. The plumber is coming in the afternoon tomorrow to try to fix the mixer tap in the shower in the second bathroom. I will try to get up to the hospital tomorrow morning to see how mum is getting along, but for the rest of today she's going to have to go it alone. In the end we're all going to be alone anyway. We face the end alone just as alone we face the many trials during our lives that really test our mettle. Sleep well, mum.

Saturday, 28 May 2016

Mum chipper despite antibiotic resistance of infection

I went up to the nursing home this morning not knowing what I would find. Yesterday the GP had called me on the phone to tell me that the most recent antibiotics mum had used would not work because the infection in her leg is resistant to them. That went for both the IV antibiotics and the oral drugs. He also said that there was one more oral antibiotic drug that might work, and he would start mum on a course of them. But the nurses realised later that mum was allergic to this drug..

Nevertheless, mum seemed to be quite well when I went into her room. While we were talking to my brother on the iPad the nurse came to change her leg dressings, and despite the fact that we were talking with my brother I waved her in so that she could start immediately. She had said that she could call back later to do it.

The right leg is the one that is badly infected and there are two adhesive bandages: one on the right side of her lower leg, and one on the top of her foot. Both bandages are covering sores and the one on the foot seemed to be weeping in part of the sore. The leg itself is not as red and hot-looking as when I had seen it during her most recent hospital admission, but it is still pretty affected by the infection. It is the one that has stopped mum walking with me to the park.

We were talking about a faerie book that had come out in the 70s, when I was a teenager, which was a kind of catalogue of dwarves and elves. I asked my brother about it and he went online to try to find it, although he couldn't. Mum said she had elves in her room. I think she said this in reply to my statement that the book was so remarkable, for me at the time, because it so scientifically classified all these imaginary creatures. Mum said she had elves among the leaves she collected from the park and brought back inside. She's the only resident to bring assorted leaves off the ground back into the nursing home, so she's a bit remarkable herself in that way.

She told my brother that she doesn't mind dying, and that she'll just slip away. I think she said "slither away" at one stage, which was funny for us because my brother keeps snakes in his house. She said that she will just slide away when her time comes. "I don't mind," she said. "I have lived long enough. How old am I?" I told her she was 86. "Yes, well 86 is quite old enough, I think," mum added. We'll have to see how these latest antibiotics work. There is another option for her if they do not work, but I think it might be a bit intrusive for her. According to her advance health directive it might be a bit too much for her to handle. I can just imagine the fuss she would make if the hospital staff started to put a line into her neck.

Friday, 27 May 2016

Sometimes a stranger is the best person to listen

I went into the GP's office this morning to get a referral for my psychiatrist, and also to get my right ear irrigated because it was clogged and my hearing was being affected on that side. While the doctor was syringing my ear to get the wax out of the canal we chatted about my mother and her situation in the nursing home. We talked about how mum has cellulitis and whether a nursing home was a poor environment for infections generally, but he said that cellulitis is brought on by physical inaction and low resistance to infection due to old age. I mentioned that I sometimes felt guilty about my mother's cellulitis because I thought that nursing homes might be bad environments for cleanliness. He said it wasn't necessarily true.

I also talked about how I had brought mum to Sydney from southeast Queensland in December 2014 following her diagnosis for dementia in March of that year. He said that looking after someone with a degenerative mental illness like Alzheimer's can be tough. "We all like to think that we will look after our parents," he said, "but sometimes it's not always possible." He sounded quite calm and neutral about it, so I had no reason to doubt him. I am sure that he talks with a lot of people about their elderly parents in the course of his daily work. So it made me feel better.

Then I told him about how, in the middle of 2012, I stopped freelancing because looking after mum was taking up too much time. I told him of one week around that time when I had to take mum to the GP every day for a week. I have always wondered if giving up journalism was a wise move, because now I feel the lack sometimes of a guiding principle in my life. I mean, I go and see mum every two or three days in the car but at other times I might sometimes feel like I am at a bit of a loose end.

It was relaxing to talk with the doctor while he was engaged in the essentially simple task of irrigating my ears. It was quite intimate and personal, and I felt as though I had his complete attention. I don't think he minded that I talked to him in this way during the procedure. He seemed quite relaxed about it. He said that it is a novelty for people to live as long as they do nowadays. Even 20 years ago people were dying ten years earlier than they do now. I had ventured that in the previous generation people were dying at age 65 or 70. So we were on the same page essentially. He also said that because humanity is quite a recent form of life, evolutionarily speaking, we have not really yet worked out how things like old age should be organised.

Tuesday, 24 May 2016

Book Chat, Episode 4



Books talked about in this episode of Book Chat:
  • Death by Water, Kenzaburo Oe (2015)
  • To Hell and Back, Ian Kershaw (2015)
  • Flight Behaviour, Barbara Kingsolver (2012)

Monday, 23 May 2016

Book review: Everywhere I Look, Helen Garner (2016)

I seem to remember this book being talked about on TV by Leigh Sales as a book replete with positive stories but I have to admit that, for me, this strange little miscellany resembled nothing more than a collection of bric-a-brac. All very entertaining, I'm quite sure, but it's not something that has a solid core that you can easily address in a critical appraisal like the one you are currently reading.

To be quite honest the pieces that appealed most to me were of an autobiographical nature. I've not seem diary entries being used in this way by a reputable non-fiction author before, so it was something that strikes me as being out-of-the-ordinary. But I loved reading about Garner's children and beloved grandchildren. She is, of course, the age of anyone's nanna, and is well qualified to be telling people what she thinks of little Tom or whomever she is charged with keeping an eye on at any one time. There is a deep humanity at work in these whisper-slight vignettes, small slivers of time and action that capture something of lived experience in a fresh and engaging way.

Elsewhere in the book we find some of the reportage for which Garner is probably now most famous. She has spent many, many hours seated in courtrooms taking notes and observing the proceedings in camera. Here you will find some new pieces - though short ones - to add to her well-known catalogue of writing on crime and the darker parts of the human soul.

I was sometimes terribly moved while reading this book. Often I would skip quickly, with a sigh, from the end of one piece to the beginning of the next, eager to discover what new gem Garner had chosen to display for my entertainment and instruction. The difficulties of other people's dogs, the problems with being of a certain age and female, or the wonder of small boys who say outrageous things without even meaning to. Life is a puzzle. But you'd have to say that despite the irregular construction of the whole the parts are very much worth the reading. And finishing up with a tour-de-force on the non-linguistic medium of ballet serves to highlight most forcibly the rare quality of Garner's art.