Category Archives: Caregivers

Reality – Let’s Dwell on the Now!

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So I decided to write this while it was still fresh in my head.  I really should do that more often, but it all ends up being said in the end regardless, so it’s ok.

Today was a check-up appointment for Patrick with Nephrology.  This is the second time in a row I’ve come out of an appointment with information I didn’t have previously.  I am known to ask questions of the doctors and nurses, and they know I will continue to ask questions and talk to them till I am comfortable in my understanding and knowledge of whatever the issue is.  It looks as though I will need to start asking more detailed questions about reports, tests and scans.  I have also requested all clinic and hospital reports for the past year and all scans since 2005.

Let me start by saying that the update I’m about to give, may not sit well with many and I will emphasize repeatedly that we are/everyone is to dwell on the positive aspects of this information.

Without going into extreme details, I will begin with a bit of history that perhaps some don’t know or didn’t realize.  One of the ‘symptoms’ that typically goes with Patrick’s diagnosis of Meckel Syndrome, is polycystic kidneys.  This means that it is common for the kidneys to have and/or be covered in cysts.  The cysts get so bad that the kidneys end up having problems functioning and eventually shut down.  When Patrick was born, no cysts were detected or found.  A few years ago, a few started showing up on his ultra sounds.  There were only about 3 in total.  There had been no real issues with his kidney function…till about 4yrs ago.  It started to decrease.

In April of this year, we found out Patrick was in Stage 2 Chronic Kidney Disease and his kidney function had decreased to 60-65%.

Now, let’s jump to the present.

The appointment this week has brought some more information to light and also given us a bit of a reality check about this issue.  We’ve always known his kidneys were and were going to be an issue, but it’s always been tucked in the back of our minds as there hadn’t been any major issues and he was being managed well to look after them as best as possible to prolong them as much as possible.

Information this week has told us, Patrick’s kidney function is now 50%.  He also has more cysts on his kidneys.  The bigger Patrick gets, the harder it will be on his kidneys.

The Doctor told me that when his function gets to 30%, we will begin having talks about what will be the options for Patrick and what will be in his best interest.  A number of factors will come into play at that time, so it’s not something that can be discussed to much this early on.  The Doctor also mentioned that sometimes it is good to begin to discuss some of these things now, as it is generally more difficult in the ‘actual’ moment and our judgement can be ‘clouded’ sometimes in those types of situations.

They are managing him as best they can, as I mentioned, to prolong his kidney life as long as possible.  Some of the things they monitor are his phosphate and potassium levels, his blood pressure, his meds and a few other things.  Patrick’s ‘numbers/levels’ are good at this time under the circumstances, and that’s a great thing!! It means he’s being managed well!  Let’s keep that in mind!

Not to put a damper on things, or to sound morbid, but to a degree the reality of the situation has been brought a little closer to the front of our minds now.  The reason being, if his function continues to decrease at the rate it is now, we’ll be having these talks within 2 yrs.

But let’s try not to dwell on the future too much at this moment.  Patrick is a happy boy!  He loves school and being around his friends and family!  He loves to do crafts and bake!  He loves going for drives and music!  He’s an amazing young man!  He’s doing better and being looked after by the best people!  His numbers are good at this point as mentioned previously, so again, his health is being managed well at this time!

 

How can you smile not smile at this guy?

 

Minimize admissions – maximize quality of life

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A quick update.  I’m sorry I won’t be going into it all right now, but I am just too tired and need to get to bed.  Patrick’s respite workers are finding it tiring when here as well.

Patrick is being admitted tomorrow morning to hospital.  A Shunt-o-gram is being done and the idea is that during this admission, the G-Tube and possibly the 24hr EEG will be done as well.  This admission will likely be approx 2 weeks, give or take a few days depending on how everything co-ordinates.

Trying to do as much as possible in an admission to prevent the back and forth between hospital and home.

A lot has gone on and been talked about and discussed yesterday and today and I will try to update when I have time while in hospital with Patrick.  I really need to go to bed now.  I still don’t have everything ready for tomorrow!

We welcome all thoughts, prayers, support and hugs and thank you for them as well.  Visitors are especially welcome to come see us.  Message/text/bbm or call to find out what room we are in.

Goodnight my friends, tomorrow is a long day, be in touch soon!

 

Are you ready to talk about it?

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The talk.

The talk no one likes to discuss or have.

The talk no one ever seems to be ready for.

How can you prepare for something that makes so many people uncomfortable?

Let me again say, no one is expecting Patrick to not make it through surgery.  We’ve been told it’s rare that children die on the table.  This is still a conversation many people must have at some point or another.  It’s particularly difficult when it’s your own child.

Patrick’s father was up for the weekend to see him (for those who don’t know, we are divorced, he sees him fairly often) and we had a couple conversations regarding what the other thought regarding resuscitation.  Not an easy conversation.

What do you do?  What do you say?  Many thoughts and questions come to mind.

Some will say he has been through enough.  Some will say he’s always come through.  Some will want the chance to say good bye.  Some will ask would he still be Patrick after?

Some family members have shared their thoughts with us already.

How many of you would be able to make that choice for your child? Do you think you would be able to tell if your child is suffering or not?

Could you make the decision selflessly?  It’s difficult as a parent, because that’s not the way it’s supposed to be!  Your child is going to outlive YOU right!?

We haven’t come to a decision yet.  I don’t think either of us are ready yet to do so.  I want to speak to the Doctors once they have the plan and get their thoughts on everything.  I want to have as much information as possible about this before making that decision.

What we do know is that since Patrick’s last cranial vault expansion, his health has not gone back to was it was prior to that.

We are NOT looking at this and expecting a negative outcome!  We are NOT planning on saying goodbye!

We DO have to be prepared and accept the reality of the situation and make decisions in the best interest of Patrick.

How do you think you would/will cope?  What things would/will come to your mind?  How difficult do you think it would/will be?

We’d love to hear your thoughts/experiences.

 

 

 

 

Improving Quality of Life

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Many of you are wondering how the meeting with supportive services went this morning.  Here is a bit of a run down of what the plan is and what’s happening.

 

Let me begin by telling you, it was decided this morning’s meeting would not cover any of the difficult palliative issues at this time.  Those talks will happen, but today the priority was pain management and quality of life concerns.

Patrick’s pain seems to be managed fairly well with the medication he’s on.  He’s taking Gabapentin and Valproic Acid.  He doesn’t complain of headaches as often as he had been, which is good.  Tylenol is being used when needed to help take the edge off at least.  It really doesn’t do much for him honestly and thankfully is not needed as often at the moment.

As for quality of life, fatigue is making Patrick’s not so good.  He is awake and alert for periods throughout the day, but they don’t last and he tires easily and quickly and falls asleep.

What is causing the fatigue?  We wish we knew.  The Doctors wish they knew.  Could it be the meds?  Possibly.  Could it be the increased pressure in his head? Sure.  Could it be the seizures?  Again, it’s a possibility.  The fact is, he has been like this before when seizures and medication weren’t in the picture.  Both the seizures and the meds won’t help it indeed.

It’s so difficult to write so much out and so that many will understand.  It’s easier to inform verbally, but I will do my best.  I have considered doing videos instead of writing for updates, I may still, we’ll see.

Fatigue is causing issue and concern with eating and drinking.  He’s so tired, that it’s taking 2-3 hours to get through meals and drinking.  Tiring, not only for him, but for the caregivers as well.  The decreased alertness and increased sleepiness while eating and drinking can become a serious health and safety issue for Patrick.  Not being awake enough to chew and swallow properly can cause him to cough and choke and potentially aspirate.  Chances of pneumonia increase with aspiration, something he can’t get.  We’ve been lucky thus far, but he does cough alot when trying to eat and stay awake enough.  He wants to eat, but it tires him so much.  It’s alot of work to co-ordinate chewing and swallowing, something many of us don’t realize or think about.

A consult for a feeding assessment is being done as well as a recommendation that Patrick have a G Tube put in.  The G Tube will not be to replace his eating, but to help.  He will still eat what he wants and can, but in a 20-30min time period.  Anything after that will be done by the G Tube.

By doing this, the hope is to improve his quality of life, even if just a bit more and hope that it preserves some of his energy and that maybe his awake/alert periods could possibly start to become longer.

A social worker is going to be asked to become involved as well.  As I am usually the one who looks for information and resources for most things I need to know, I’m so tired, I’ve not had the energy to do a whole lot.  As Lisa (support services person) told me this morning, she has no doubt how tired I am (you just have to look at me) and that I am doing a great job and being a great advocate, but it will be nice to have someone else involved who can advocate for me/us and do that extra stuff for me.  Looking for information and resources.  A little reluctantly, I agreed.  Social work is apparently going to get me more information on Kids Country Club (their website is down), a respite for children who are technology dependent and medically fragile.

I hope to hear from Neurology next week regarding the 24hr EEG.  My thought is now that with them deciding to put a G Tube in, it would make sense to co-ordinate the two since he will be in hospital 4-5 days with the G Tube.   Hopefully this will be done sooner than later, so this surgery can get done and he can start recovery and get better.

Lisa did make a point of saying that no one is thinking he will not make it.  The reality of it is though, this a very big, complex and complicated surgery and the risks are great.  Everyone needs to be prepared for ALL the possible outcomes.

I’m tired and can’t think of the rest at the moment, so I will sign off and update again later.

I did get a call this afternoon though from Neurosurgery Clinic saying they wanted a CT today/tonight or tomorrow for Patrick.  He’s having it 730am tomorrow morning.  I’m off to bed to get some sleep.

Goodnight my friends, thank you again everyone for your kind thoughts and prayers! HUGS!

 

Supportive Services = Palliative Care Team

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I had posted a bit of an update the other day on my FB status.  It was in response to a family member asking for the latest update on Patrick. Based on reactions to my status tonight, it is quite clear, not everyone saw/read it.

I apologize.  I should have posted the update IN my actual status or here on my blog.  I’ve been so tired to do any length of updating, it’s just much easier to talk to someone in person or on the phone.

Here is the update I posted the other day…

Waiting to hear from Neurology to see when the 24hr EEG will be. They have told Neurosurgery to hold off on the surgery till the seizures are managed. I left a message for Neurology this morning. Supportive Services (Palliative) called this morning and are coming to the house on Thurs to go over things etc…

Patrick is doing ok. He has bouts of animation, but still tires easily. Dietition has been in and he is needing to have 2 supplements/Ensures a day to make his caloric intake. OT is coming out this week to discuss energy conservation for him.

As the day goes on, he tires more. A nurse comes to the house 2x a week. He will get his stitches out today and will need a port flush in the next couple weeks.  (stitches came out yesterday, port flush next week)

CCAC has given me information on services I can hire to come in at night if I decide to use a PSW or Nurse to keep an eye on him through the night. If I go this route at some point, it will be a nurse coming in, not a psw.

The money I have for respite can be used to pay for that service as well. It will just take those ‘hours’ away from the girls. Im going to call VON and see if there is additional funding somewhere so I don’t have to use those funds if I decide it’s necessary to have someone come in at night.

 

I used the term most are familiar with, perhaps that was a mistake, but it has also made people realized how serious this surgery will be.  Supportive services will be supporting us leading up to, during and after the surgery.  They will also be preparing us for things in case the outcome of the surgery is not what everyone is hoping for.  No one wants to think negatively, but we do have to deal with the reality of the situation as well.  Neurosurgery thought having them involved was a good idea for this.

In all the surgeries Patrick has had, I have never once thought he would never come out.  I will maintain that thought through this one, but as I mentioned, I have to look realistically and be prepared for this one.  This is a complicated and very long surgery and one that no one, even the Doctors are looking forward to.

I have my moments with things.  I’m tired.  I miss seeing friends and family, but very much appreciate when they stop by for a visit here to see us.  It makes me feel like I’m still connected to the outside world and provides a nice distraction, even if only for a little while.

We appreciate all the thoughts and prayers everyone has been sending.  Those who have dropped meals off because there are days I’m too tired to think about cooking or remembering to take something out to cook, it’s truly appreciated! Thank you!  Our schedules have been off because of Patrick’s tiredness, so meals are not always at meal times.

Thank you everyone, I will try to keep things updated, but please don’t hesitate to call or message or come by for a visit if you’re wondering how things are and have not seen a recent update.  I am tired.

HUGS to those who need them and thanks for those sent back! :)

 

Heroes in the home

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What is your definition of a Hero?  Do you know any Heroes?  Do you consider anyone a Hero?

Have YOU ever been called a hero?

What a way to start off this post asking so many questions.  Wait, I have more!

Are you a caregiver?  A Mom?  Do you look after a family member or friend?  If so, YOU are a Hero!

There are different definitions of a Caregiver.  Wikipedia has an interesting definition of Caregiver:

Carer (UK, NZ, Australian usage) and caregiver (US, Canadian usage) are words normally used to refer to unpaid relatives or friends of a disabled individual who help that individual with his or her activities of daily living.

The words may be prefixed with “family” “spousal”, “child” to distinguish between different care situations, and also to distinguish them definitively from the paid version of a caregiver, a Personal Care Assistant or Personal Care Attendant (PCA). Around half of all carers are effectively excluded from other, paid employment through the heavy demands and responsibilities of caring for a vulnerable relative or friend. The term “carer” may also be used to refer to a paid, employed, contracted PCA.

The general term dependant care (i.e., care of a dependant) is also used for the provided help.[1] Terms such as “voluntary caregiver” and “informal carer” are also used occasionally, but these terms have been criticized by carers as misnomers because they are perceived as belittling the huge impact that caring may have on an individual’s life, the lack of realistic alternatives, and the degree of perceived duty of care felt by many relatives.

More recently, Carers UK has defined carers as people who “provide unpaid care by looking after an ill, frail or disabled family member, friend or partner”. Adults who act as carers for both their children and their parents are frequently called the Sandwich generation.

A general definition of a carer/caregiver is someone who is responsible for the care of someone who is mentally ill, mentally handicapped, physically disabled or whose health is impaired by sickness or old age. To help caregivers understand the role they have taken on, “Next Step in Care”[2] outlines the following:

You are a caregiver if you:

  • Take care of someone who has a chronic illness or disease.
  • Manage medications or talk to doctors and nurses on someone’s behalf.
  • Help bathe or dress someone who is frail or disabled.
  • Take care of household chores, meals, or bills for someone who cannot do these things alone.[3]
It’s my Duty Isn’t it?

With an increasingly aging population in all developed societies, the role of carer has been increasingly recognized as an important one, both functionally and economically. Many organizations which provide support for persons with disabilities have developed various forms of support for carers as well.

What is YOUR description of a Caregiver?

As caregivers, I don’t think we give much thought to what we do.  We just do it.  It’s natural, it’s what we do.  We become masters of multi-tasking, juggling appointments, preparing lunches and making meals, transportation, cleaning, laundry and more.  We are teachers, doctors, nurses, chefs, handyperson’s, therapists, advocates/speakers, to name a few, all wrapped into one.

When was the last time someone complimented you on everything you do?  When was the last time someone thanked you for all you do?

When was the last time someone called YOU a Hero?

It’s not always easy or comfortable to hear those words, because to us it’s what we do all the time.  It’s our life!   It’s still feels good to hear them though, when we do.

Often people ask me; ‘How do you do it?’  My response of course is, ‘Do what?’  They reply;  ‘Do everything you do with/for your son, and all the things you are involved in.’  What is our usual reply to a scenario like this?  This is my life, I just do it.  Just like you do everything you do in your life and for those around you.

Being Mom to a child with disabilities, we face challenges that many others don’t have.  We all have different challenges in life we go through, but some are more specific, I’m sure you understandwhat I mean.  I hope you do.  We don’t look for pity.  We don’t want you feeling sorry for us and all we go through.  We are proud, just like you!   It’s difficult for many of us to ask for help and/or support for whatever it is we might need.  Although there are days we think we must be superman, we know we aren’t.  It’s tough for us to take time for ourselves, but we learn, slowly and it’s something I don’t think any of us perfect.

A week or two ago, one of my son’s workers asked my permission to nominate me for an award through CCAC (Community Care Access Centre).  I wasn’t sure what it was about or for, but she needed my permission to submit my name.  Since things have been so busy with Patrick the past month, all I got was that it had something to do with being a caregiver.  I gave my permission and honestly didn’t think about it again, till this past Friday when I received a letter in the mail from CCAC.

An initiative of South West CCAC and the healthline.ca

Congratultions!

We are pleased to inform you that Michelle S. has nominated you for a

HEROES IN THE HOME Caregiver Recognition Award!

There is a special celebration  on October 20th to receive this award.

WOW!  How sweet of Michelle to think so much about me to feel I would give justice to and deserve this recognition.   I really am blessed!  The girls who come work here, love working for/with Patrick and I.  We become like family and care for and about each other.

How amazing someone thinks of me as a Hero!  It’s an indescribeable feeling.  I’m just me after all, always am, have been and always will be.

I am very grateful for everyone in our life who loves and supports us.  I am grateful for all the things, whether big or small that anyone does with and for us. I often wonder how I could ever repay everyone for all the kindness, love, support etc that they have shown us.  It truly is overwhelming some days and I don’t think I could find enough words to express it.

For tonight though, I will say thank you!  Thank you to all of you!  May you know you are loved and thought of fondly often.

For tonight, I will check on Patrick before I crawl into my bed, and fall asleep knowing that someone thinks I’m a Hero.  And I will let myself have warm fuzzy feelings, even if it’s for a short time because tomorrow I will wake up and do it all over again.

Let me leave you with one more thought…

YOU are a Hero too!!