This disease finally made me cry
I'm pretty emotional. I cry when watching movies and reading articles and reading posts. But I have shed just a handful of tears in the 16 years of my husband's life with Alzheimer's. I chose to view it not as a tragedy but as a new condition of our life. I focused on what I could do to make his/our time as wonderful as possible. But in the past week, things have changed dramatically and I am a bit stunned, and so sad.
Until this year, we lived with slow cognitive decline. This year the disease has started to affect his physical systems. Here is the parade of health events: A seizure, a bad month of anti-seizure medication, ER for what turned out to be Myoclonus (involuntary muscle spams or jerks), two unprovoked falls, a bout of cellulitis, another seizure. despite these we were doing well. We were still attending community events, taking little walks, laughing. With PT his posture was good as was his ability to stand and sit. Then the myoclonus came roaring back, this time so frequent and strong that it wakes him up, preventing good rest. The latter surfaced a week ago. Last Friday, he was uncharacteristically subdued, tired, and was bowed over and extremely hesitant to walk.
Our wonderful neurologist recommended that we try a different anti-seizure medication that is known to help with myoclonus, Brivaracetam. I had decided before this that I would not put him on any anti seizure drugs because the first one we tried, Keppra, had such a sedating effect on him. But now I was faced with his real discomfort (he exclaims, "oh!" or " Oh no", in response to the larger myoclonic spasms) and the secondary effects on his ability to engage and his mobility. So we started the medication on Monday.
The myoclonus is significantly better, but still causing him to wake up. He has become progressively more sedated, He does not have the energy to be himself-- loving, cheerful and engaged.
Today he slept almost all the day and was barely able to walk. Unless the sedation effect subsides, it looks like I will have to choose between having Gary in discomfort and tired from the myoclunus, or sedated, minimally communicative, and soon non-ambulatory from the medication. The most heartbreaking part is that I am having to administer the very substance that is sending "him" away, making his spirit inexpressible.
Has anyone had experience with these anti-seizure meds? Do the sedation side effects diminish significantly over time?
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@shmerdloff
Thanks for always reminding me to face reality--my reality.
You are heroic--as is @memoriestomoments.
In contrast, I am a lost cause, dreaming "the impossible dream, fighting "the unbeatable foe," bearing with "unbearable sorrow [t]o run where the brave dare not go."
I am still hanging in there even though my friends tell me it's time for George to go to a care facility. Too often, I feel that caregiving is killing me; but I am still convinced that :
"...I'll only be true
To this glorious quest
That my heart will lie peaceful and calm
When I'm laid to my rest
And the world will be better for this
That one man, scorned and covered with scars
Still strove, with his last ounce of courage
To reach the unreachable star!"
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9 Reactions@georgescraftjr
🫂😢😩💔
@trishaanderson someone finally put the words in perspective. I have though it but never said it thank you
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4 Reactions@memoriestomoments It sounds as if you are doing everything possible to alleviate Gary's discomfort. He is blessed to have you at his side loving him and doing what needs to be done. It is a really difficult situation for you as well as him because there is no care plan that fits every dementia patient and their specific issues. It is a trial and error mission. I think it is not unreasonable to hope to find a medication that will relieve his pain but it may come at the cost of sedating him which may help with the sleep situation. It might be helpful, if you are not already doing this, to keep a log with the help of the watch, of how much sleep he gets each night so you can share that with the gerontologist and neurologist. Also his level of discomfort as best you can determine with his help. I think it must be a simple scale, not the 1-10 we use in the medical field. Maybe a "little discomfort/pain", "more than a little," and then "a lot." He may not be able to grasp what you are saying if his cognitive function has
declined. With my husband I have to use visual clues to get my question/message across
because his ability to grasp the meaning of what I am saying has declined. He also has chronic back pain for which his pain management physician has prescribed hydrocodone 5mg/acetaminophen 325 mg. It seems to be an effective dose. I would also include the location and approximately how long it lasts. Anxiety is a common symptom of dementia since I think the person feels on some level that things are not right. He may not be able to express it and that causes his distress and anxiety. I think consulting with the gerontologist is a good idea. She/He may have more insight as she/he deals exclusively with older people among whom dementia is increasingly common. With dementia, more accurately called brain failure, the entire brain is failing. Which areas will be affected first may vary from person to person but they will all at some point be diminished. For example, my husband has lost his peripheral vision and now has what is called binocular vision, he only sees what is directly in front of him. I know that at some point he will stop eating and drinking though he may have swallowing difficulties before that. Right now he chokes sometimes when he eats. He sleeps all day, only gets up to go to the bathroom. He will begin to sleep more, eat less and have a harder time communicating. My plan is to make everyday that I still have him count. I give him pain medication whenever he says he has back pain. Sometimes I have to ask him "how is your back today?" because he will not tell me if I don't ask. I tell him every morning that I love him and he is the best thing that ever happened to me. I also reassure him that I will always be at his side and together we will face what ever the future holds. To me the quality of his life is my top priority, not the length. I have a pretty good idea of what will happen because of previous end of life caregiving for my parents and have been an RN for over 50 years. I know that I can handle the physical caregiving but the grief and loss of the love of my life will break my heart for sure.
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8 ReactionsIam thinking of you. Prayers,,,🙏
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1 Reaction@ocdogmom Thank you! I have been documenting the key aspect of each day in a notebook but found that I needed to do a lot to summarize the pattern in preparation for the visit with the gerontologist. I will create a table with codes so that the pattern is clear by looking at the table. ( My own background is in high tech management, so this is the kind of stuff I did a lot 🙂 )
I am so sorry to hear of the different kinds of discomfort and outright pain that your husband has had. The sleeping is a blessing.
We, also, have love as our key food and medicine. Today my husband was a bit more present than he has been. I kissed him and said "I love you. But you know that, right?" He nodded and said "M-hmm". I said "Well I'm going to keep telling you anyway!" "Ok."
You may have seen my next post on entering hospice. This is requiring some adjustment in my expectations, my management of the caregivers, and probably my sleeping arrangements (I will sure hate to lose sharing a bed!).
All the best!
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