Another Morning Conversation

Today is the day after St. Patty’s day.  So what?   Nothing what except we are now three days into the asinine idea of Spring forward.  In another week or so we will be adjusted to the new med schedule but not yet.  I could spend several paragraphs discussing the odd arguments pro and con to the whole idea of time change but it seems to boil down to a cover-up for a scheme to get more golf daylight without having to negotiate with each individual employer to do so.  Who started this idiocy?

What a mess with a parkie!  For those of you who are not taking care of a Parkinson’s patient on a daily basis, it is a crisis in disguise.  The medication schedule is off by an hour all day long.  I know from previous experience she will be miserable for about thirty minutes before each dose and then about thirty minutes after each dose as the meds kick in and the chemicals stabilize.

Assorted confusions appear in her mind.  Early this morning when I got up and brought her her first dose of everything all seemed normal.  I sat on the edge of the bed and waited as she did everything she needed to in the bathroom and then took the collection of pills I had set on the bathroom counter.  When she was done I took the little glass bowl we use and the water glass back to the kitchen.  Usually when I return from that we have a little discussion about what is happening that day as she is deciding to lay down a bit more or stay up.  Today, she was still standing at the bathroom counter waiting.  I asked her if she needed something else and she responded with she was waiting for that guy to bring more pills.  I convinced her that there were no more pills for a few hours. And we had to go nowhere until noonish when her exercise class began.  She seemed satisfied with that and we napped for a while more.

I awakened about an hour later and realized she was in the bathroom again so I got up. In the daylight savings time darkness I could see she had laid out some clothes that she might wear if she was going to church. I gently pointed out that we are not going to church. We were going to exercise class later. Anger and confusion appeared so I went to the living area to prepare for the miny tirade with some coffee.

In the kitchen I helped her get some cereal and dried fruit for breakfast. Life cereal with dried cherries is her favorite combination for breakfast with some orange juice. She ate that and I had some scrambled eggs with toast.

Afterward she started. One minute we are going to church, the next minute you say we are going to a funeral, and now you tell me it is an exercise class. Which is it! I do not understand why it keeps changing. Pointing out that she was dreaming and when she awakened she continued on in the dream, although appearing to be the case, was not the explanation she wanted. She was certain someone (me) was trying to purposely confuse her and she was tired of it.

Joe Dater – cartoon

Last night was very tiring she told me. You mean the business with the address list? Yes she said. I thought there would be more so I took my coffee to the chair I often sit in. On the previous evening she was organizing her birthday and anniversary card list. I had hoped to help her and simplify this activity last year with a new planner from Staples. All of the information I have installed in a spreadsheet that Avery can read so that I can print labels for each card. I printed labels and last year she carefully pasted the label information on the proper page in the new planner. Each month she gets out two or three old hand written address books left over from her mother and from her office before we moved to the condo minimum. I asked where the new planner book was and she responded that she uses that but it was going to take a year or longer to get the correct information in it. I incorrectly pointed out that she had put the information in there last year which caused an angry response so I quit talking about it. Eventually she became tired, took her night time meds and went to bed. So did I. It was early for me too.

And then she became calm. She got her sewing project and sat down to watch the early morning news with me for a bit. And I might be understanding the confusion. The old address books are crammed with a lot of info in a small space. The planner — being a planner like a teacher might use — is organized by month and day. We labelled it with the correct info on the correct day but her cognition no longer allows for that recognition. To her, it is a big black book with almost no information in it. I may have to create a cross reference by name and family.

Exercise is more effective than drug therapy

On the way to class she suggested that we go somewhere for lunch. It started goofy but it may turn out to be a good day.

We went to our old favorite diner for lunch after the exercise class. We had not been there for more than a year. Her conversation was about the diner and old remembrances. The diner had been painted and the ceiling had been replaced. It was much brighter inside. Often something on the menu in one of these places will spark a memory of part of her family. This time an old friend that we had not seen for awhile strolled in to have lunch with her friend.

The pandemonium seems to slowly ever so slowly to be breaking free. “Hallelujah” is on the music loop at the exercise class.

Sadly the daylight will be saved whether it needs to be saved or not. Personally, I think not. The system is idiotic. Keep in mind China has only one time zone. Geographically that country is as wide as the U.S.

Chart from the U. S. Navy

And Parkinson’s will still suck. Just more so while we stand still and the time zone shifts left or right.

Two New Arrows in the Quiver or Better Living through Chemistry

Ondansetron for nausea and Quitiapen for a sleep aid. How are they working?

Ondansetron Hydrochloride

The drug for nausea – Ondansetron – seems to work very well. I have adjusted when Cheryl takes it a bit. The instructions merely say three times a day and at first I interpreted that to mean 7AM, 1PM and 7PM which are normal times for her to take meds. For the past couple days I have given her the evening pill at about 5PM which is 45 minutes to an hour before we would ordinarily eat dinner. It seems to be working for her. I have repeatedly asked her about stomach issues and she reports no issues with her stomach.

This report – no funny stomach – is very encouraging since it has been her main complaint for months. I can empathize. Over the past couple years she has lost approximately thirty-five pounds of weight. The dyskinesia puts her body in constant exercise but the combination of no sense of smell and a slightly uncomfortable stomach keeps her from eating much. (During this whole time she has not vomited but as she says, it is right there.)

Quetiapine Fumarate – 25mg

The drug used as a sleep aid – Quetiapine – might or might not be working as hoped. She is prescribed 1/4 of this little pill before bedtime (10PM). Shown above it is approximately 1/8 inch in diameter. We have a pill spliter but these are not scored for cutting in half as many pills are and certainly not scored for quarters.

The first night she took this she slept completely through the night. This was the first time in approximately two years. The second night she got up once. The third night she got up once and seemed restless for a bit when returning to bed. The fourth night was similar to nights before she started taking it. I am not convinced that she is getting the same dose each evening, so I will find a way to slit these tiny little pills as uniform as possible.

An update: Last night seemed better. She used the walking frame for stability. Only once.

Zofran — From Wikipedia —

Ondansetron, sold under the brand name Zofran among others, is a medication used to prevent nausea and vomiting caused by cancer chemotherapy, radiation therapy, or surgery.[2] It is also effective for treating gastroenteritis.[3][4] It is ineffective for treating vomiting caused by motion sickness.[5] It can be given by mouth or by injection into a muscle or into a vein.[2]

Common side effects include diarrhea, constipation, headache, sleepiness, and itchiness.[2] Serious side effects include QT prolongation and severe allergic reaction.[2] It appears to be safe during pregnancy but has not been well studied in this group.[2] It is a serotonin 5-HT3 receptor antagonist.[2] It does not have any effect on dopamine receptors or muscarinic receptors.[6]

Ondansetron was patented in 1984 and approved for medical use in 1990.[7] It is on the World Health Organization’s List of Essential Medicines.[8] It is available as a generic medication.[2] In 2017, it was the 83rd most commonly prescribed medication in the United States, with more than nine million prescriptions.[9][10]

Seraquel — From Wikipedia —

Quetiapine, sold under the brand name Seroquel among others, is an atypical antipsychotic medication used for the treatment of schizophrenia, bipolar disorder, and major depressive disorder.[6][7] Despite being widely used as a sleep aid due its sedating effect, the benefits of such use do not appear to generally outweigh the side effects.[8] It is taken by mouth.[6]

Common side effects include sleepiness, constipation, weight gain, and dry mouth.[6] Other side effects include low blood pressure with standing, seizures, a prolonged erection, high blood sugar, tardive dyskinesia, and neuroleptic malignant syndrome.[6] In older people with dementia, its use increases the risk of death.[6] Use in the third trimester of pregnancy may result in a movement disorder in the baby for some time after birth.[6] Quetiapine is believed to work by blocking a number of receptors including serotonin and dopamine.[6]

Quetiapine was developed in 1985 and approved for medical use in the United States in 1997.[6][9] It is available as a generic medication.[10] In the United States, the wholesale cost is about US$12 per month as of 2017.[11] In the United Kingdom, a month’s supply costs the NHS about £60 as of 2017.[10] In 2017, it was the 76th most commonly prescribed medication in the United States, with more than ten million prescriptions.[12][13]

This website Drugs.com has pictures and characteristics of everything.