Wednesday, October 27, 2010

A Fragment of Vision!

     I have spent  a few days twice during the last month taking care of my 93 year old mother after she had cataract surgery. She is basicly blind from so called "wet" macular degeneration. But she had enough peripheral vision to get around in her own home to live independently. In fact, she still bakes cookies and makes macaroni salad and potato salad ( her own recipe with both mayonaise and Henri's Tastee Dressing) to take to church pot luck events and fundraisers. However, lately her vision shut down in both eyes due to a rapid progression of her cataracts. Now in today's world of discussion about money spent on seniors and particularly during the last months or year of life, one might say: "Why would you do cataract surgery on a lady who is already blind from macular degneration?" It is a reasonable question. But this 93 year old woman still lives independently by herself, still contributes to the community, and is still sharp as a tack with her mind. How do you deny such a surgery to her, even if it only provides a miniscule improvement in her vision? Well, fortunately her retinal specilist agreed and found a doctor to do the bilateral cataract operations as soon as was possible. Well, this 93 year old breezed through the surgery. Oh, she was a little nervous about the first surgery; her systolic blood pressure reached 180 probably due to this anxiety. Indeed, she had only had surgery of any kind once before in her life -- the removal of a diseased gallbladder more than 30 years ago. And this was an operation on the eye for which she would be awake. But a little short acting IV sedative (Fenenyl) and she breezed right through the surgery. She said it went so fast she thought they were just preparing her eye for the surgery and she was told that it was over. (Well, this adept eye surgeon averages 7 minutes per patient of actually removing the cataract. The patients are moved through at about the rate of 30 minutes per patient in the OR.)  Of course, it might have also helped that I was with her, a retired physician, and even more so that her second daughter works as a teaching RN in the operating room of that hospital and could keep us all posted on exactly what was going to take place when. Mom was discharged from the recovery room about 2 hours after the surgery ended.  I stayed with her for 2 nights after each surgery. I could tell an improvement after the first one. Before the surgery she had begun to feel around just to get past the table in her kitchen, or to get through doorways. She had become uncertain and indeed a little unstable on her feet. The family feared a fall would put her out of commission for good. But immediately as we arrived home after the first surgery I noted that she was moving around with more confidence. She knew where that table was and where the edge of the door frame was. And as the swelling cleared, she could begin to use her machine which magnifies print such that she can read a few words again. These are little things but in her case every fragment of remaining vision is important.
     She is looking at a long and lonely winter. She used to be one of 4 widows, all over 80 in my small home town of Pecatonica, IL. But now my aunt has entered a nursing home near her daughter in central Illinois. My 94 year old cousin has had to stop driving and has been in and out of the hospital and is currently in a nursing home recovering from one of those hospital stays. The 4th widow also has macular degeneration and is also suffering from dementia. My mother's local support system is being decimated by age and debility. We three daughters will have to attend to her more frequently this winter and we are thinking of employing a companion to come in a couple of days a week to just be there for Mom. She was getting sick of the Talking Books that were coming in the mail, so I updated her subscription there and am getting her some Talking magazines and some newer and different books topics. She "watches" some television and enjoys the History Channel. We are keeping that going. Phone calls from family members help and her fellow church members are wonderful about taking her to church events and to her doctors' appointments.
     All of this prompts me at 67 to consider what my husband and I might need in our old age. One never knows how the cards dealt to us are going to play. We can plan for some expectations such as having long term care insurance in place, but we can't forsee everything. I just hope I have a family and a support group like my mother's and the strong will and determination that she has at this advanced winter of her life.

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