Feet, Hands, Head, Heart, and Points In-Between

ejourneys

Feet, Hands, Head, Heart, and Points In-Between

ejourneys
(From the Community Caregiving Journal 3-word prompt Club, Thunder, Pour.)

This has been a mixed, slow, exhausting, but on balance a pretty good week.

My partner is again on antibiotics (both pills and drops) for her toe. We were back at the podiatrist on Thursday. The results of the latest culture will be in on Monday, when we see him again.

I'll just say that the timing of her foot soaks (and hence our sleep cycles) has been chaotic at best. That can't be helping her toe any, but it's what we've got. And when her soaks generally take from two to three hours instead of the "normal" 20 minutes (now 40 with the antibiotics), we'll take what we can get.

Our foot soak checklist looks like this:

1. Materials to have on hand:
a. What one would normally expect: gauze and tape for bandaging, scissors, povidone iodine, antibiotic drops.
Then there's partner's "normal":
b. Egg timer, three coffee cups, one 1-quart bottle with two fill lines for water -- one to mark off a quart, another to mark off one cup. The bottle is filled to the quart line.
c. Toe separator for the drops part. My partner has cut one toe separator from the kind used for toenail painting. This is a huge improvement over her original idea of using packing peanuts.
d. Pyrex casserole dish, because she refuses to soak her foot in anything made of plastic.
e. Heating coil to keep the casserole dish warm when she needs warmth. This is plugged into a six-splitter that she can turn on and off, since the coil's slide switch to regulate the amount of heat no longer works. This is probably because of all the times she had used the blasted thing as a space heater during the winter.
f. Extra lamp to have on in her attempt to banish all shadows, so that she can spot when anything is spilling.
g. Paper towels for drying her foot and for mopping up spills. She insists on drying the mop-up towels (and anything else that gets wet) on the floor in front of the fridge, so that she can reuse as much as she can.
h. Variously-shaped sticks and blocks of wood on which to balance the Pyrex dish, which extends beyond the dimensions of the coil. Also, packs of different numbers of index cards, one pack to go under each foot of the heating coil, to keep it level. Each pack is marked with the name of a corresponding street outside the house.
i. Tinfoil to place at the end of a long wooden stick to make it more visible; more tinfoil to place between the Pyrex and the coil, to protect both.
j. A milk crate topped with wood that partner sits on when she soaks her foot. The location of her soaks are at the threshold between kitchen and dining/living room, very much in the path of foot traffic.
k. Ibuprofen or aspirin.
l. Two jackets in case she gets cold, plus her woolen hat.
m. Low plastic tub in which to transfer the soak water afterwards, since she wants to save the soak water for flushing.
n. Pail in which to transfer the soak water from the low plastic tub, which is more difficult to carry to the bathroom. Partner doesn't want the water transferred directly from the Pyrex to the pail because it makes too much noise.
o. Cork board to insulate partner's non-soaking foot, with a paper towel between the board and her foot.

I think that's it for the supplies.

2. Steps in the foot soak:
a. Check to see if partner has eaten enough and has enough water. Check to see if partner needs ibuprofen or aspirin before we begin.
b. Move foam pads to expose kitchen floor linoleum. Partner doesn't like the feel of the linoleum on her bare feet, so the floor is normally covered with foam pads.
c. Turn off the refrigerator at the circuit box so that the noise doesn't interfere with partner's concentration.
d. Fill the three coffee cups from the plastic 1-quart bottle, down to the bottom fill line. This leaves one cup's worth of room temperature water in the bottle. Place the coffee cups in the microwave.
e. Wait for partner to call to turn the microwave on. Prior to her soak, partner has moved two stacked milk crates into the bathroom. She sits on the crates and washes her foot in the bathroom sink. To do this, she has taken her bandage off; but before her soak she puts on another bandage for the short walk from the bathroom to the foot soak area.
f. When partner calls, turn the microwave on, set to 1.5 minutes. Prompt partner when the timer reaches 1 minute and then when it reaches 30 seconds.
g. While water is heating in the microwave, pour povidone iodine into a scoop left over and cleaned from a Gatorade can. The scoop is marked at the level of two capfuls. Partner does not want the actual cap used to measure out the iodine.
h. Turn off the A/C so that the fan doesn't blow during partner's foot soak.
i. Tell partner when microwave dings. Pour hot water, iodine, and cup of room temperature water into the Pyrex dish to mix.
j. Wait for partner, during which time the water in the Pyrex dish cools considerably.
k. Set the timer for 20 minutes when partner immerses her foot.
l. Maintain watch on the Pyrex dish and alert partner when it looks as though it's about to spill. This is tricky, since partner also startles easily, and also because she wants to notice these things for herself without any help.
m. If partner uses jackets, keep an eye out to make sure jacket fabric doesn't touch the coil. See step (l), above.
n. Remind partner if she starts talking and forgets to count the seconds the coil is turned on, so that her foot doesn't burn.
o. Bring partner water as needed, refilling the yogurt container she prefers to use (but not more than half).
p. Bring partner energy bar as needed (usually once during a soak), along with one-third of a magnesium pill that she has cut apart.
q. When timer dings, unplug the coil and bring low plastic tub close to Pyrex dish, but make sure not to cast shadow on anything. Wait until partner has lifted her foot and has it supported in the towel. As softly as possible, pour soak water into the blue plastic tub.
r. Move blue plastic tub near the pail. Lift it; do not slide it against the linoleum floor.
s. Wait until partner has finished drying her foot off (prior to applying the antibiotic drops) before transferring, as quietly as possible, soak water from the tub to the pail.
t. Move anything that's wet to the floor in front of the refrigerator, which is still off. Make sure to hold the wetted paper towels down with something, otherwise the exhaust from the fridge will blow them around when the fridge is turned back on.
u. Move the coil over to the side of the kitchen, out of immediate foot traffic. Do not slide it on the floor.
v. Reset the timer for 20 minutes for the antibiotic drops. Partner is now sitting on the dining/living room rug and has her foot propped on the milk crate.
w. Insert the toe separator.
x. Remove the toe separator when the timer dings. Partner has bandage and tape ready.
y. Partner needs to concentrate while rebandaging her toe. Be wewy, wewy qwiet!
z. After toe is bandaged, turn the A/C back on if necessary, and turn the fridge back on.

Sometimes partner wants music to play while the soak occurs, but only music that doesn't distract her. This involves an additional set of steps. Recently, she hasn't needed the music.

Her pill antibiotics run closer to the actual prescribed time, give or take a couple of hours in either direction. Partner tries to keep to her original schedule, rather than letting times drift. (@Trish, I shudder to think of what we'd do if partner's pill schedule were as exact as Robert's! We'd probably be in Loggerhead City.)

I admit that years ago, before her diagnosis and especially when we lived up north, I inwardly seethed at her sensitivities especially since she kept insisting she was fine. She also snapped at me a lot more back then, and I had snapped back when it got to be too much. Now that we know what we're dealing with, our communication continues to improve. Partner has been rejecting her long-standing perfectionism and is learning to embrace "good enough-ism," as she calls it. That makes a huge difference.

My understanding took another step forward after someone in our MS support group posted a link to this video on sound sensitivity in MS. That was an eye (and ear) opener for me.

Thursday night's foot soak also gave us an opportunity to try out a new product:

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Partner is usually fine on our 75-mile drives to the neuro, but coming back can be a challenge. She usually needs to urinate, but she also has trouble telling whether she really needs to pee or whether it's just a fart. (Are we in for a pour, or for thunder?) The neuro trip is a particular challenge because by the time she feels the urge we're on a long stretch of road with no public bathrooms.

Her idea of being prepared is to keep a yogurt container with a well-fitting lid in the car. (What could possibly go wrong?) I suggested using absorptive undies for the trip, but she doesn't like those. She has on several occasions described in detail how the absorptive undies can give her UTIs by how they act on her anatomy.

So I found and showed her the Travel Johns, then ordered some. She's been afraid to try them on the drives.

But she had to pee while waiting for the antibiotic drops and wanted to see if she could use the Travel John while keeping her foot elevated. Yay!

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The package we got has three Travel Johns. Each holds up to 28 fluid ounces and can be reused until full. When unused they're rolled up tight and tucked into themselves as shown above.

At first, partner didn't think she could use it. (Using it while sitting in the regular way is one thing. Using it while sitting on the floor with one leg raised is quite another.) Then she decided she would stand for the brief time it took to pee. By this time I had also brought in absorptive pads and had one between her and the living/dining room rug.

Not a drop fell on the pad.

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Ta-Da! :D

There's also a solid waste collection kit, which we haven't tried yet. From our test run, I'd say the urinal works like a charm. Better yet, partner likes it!

On a related note and at least for the moment, she is no longer obsessing over the new toilets. Yay! :-)

In fact, her obsession this past week involved the tree she's been growing from acorn for the past several years. She's had it in a window pot, where it's spent time growing long and leggy.

She wanted to get that thing in the ground like nobody's business. Naturally, everything came to a head after her toenail surgery, which threw our schedules into woo-woo. And of course, The Time To Plant! came early on Thursday afternoon, leaving us an hour to get everything done before we rushed off to the extra follow-up appointment that partner had made because her toe had been bothering her.

To her credit, she had spent time prepping for the tree planting -- measuring and marking, writing out the directions for better reading. Between that and my keeping track of time, we made a great, cooperative team with good division of labor. And only the bottom of her bandaged toe got dirty. I decided not to fret; I know how healing this kind of activity is for her. She'd been aching to get that tree into the ground.

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Another one that she had raised from acorn and planted years ago is now huge and is home to happy birds. I photographed that tree in June 2010 (a mockingbird is in the inset) and it's grown even more since then:

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Nature blessed us with thunder and a good pour on a couple of days, but my partner still checked on the new planting to make sure it wasn't thirsty. :-)

Late on Friday she was in a bit of a panic, saying that her foot felt weird. Was it the iodine? Did we have to switch to saline solution again? Should we call the podiatrist's after-hours pager? What to do, what to do? I started going down our usual checklist: did partner need food? Water? Sleep? Did we need the A/C on, off, cool, heat? And so on.

A few minutes later partner was all smiles, because she had figured out that she just needed to wash her feet. That almost seemed too easy.

Then she told me she had figured it out because the foot that had felt weird was the one that hadn't had the surgery.

(Decades ago a friend of mine had a dog who had cut his paw pad on a shard of glass. My friend had given her dog the best tender-loving care she could give him while he healed and all the attention she could spare. She told me she had figured out he was healed when he had forgotten and started limping on the wrong foot.)

What with all its mishegas (Yiddish for "craziness"), the week was pushed solidly into the Positive category by Wednesday's 12-Step support group meeting.

It wasn't so much what other people were saying, but what my partner said. In my mind, she has been moving from one club into another -- slowly, painfully, but inexorably.

She is now facing up to her MS and talking about it openly. She is adjusting to the reality of her cognitive dysfunction. I can see how hard it is for her. She still believes that CT scans had given her MS in 1982, but that belief is part of the journey, for as long as she needs to believe. Right now I see it as an anchor in this slow but radical shift that she is undergoing.

I feel a massive weight just beginning to lift. Tiny increments, but even those make it so much lighter. And I imagine that what I feel is a small fraction of what my partner feels.

The meetings close with the Prayer of St. Francis. During the prayer I saw my partner in tears and passed her my hanky, then used it myself.

As we approached the car to return home, my partner spotted this anole on the curb near the headlamps:

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(On one of the chats here, someone wondered what an anole was. I think this is a female brown anole, Anolis sagrei.)

Then my partner spotted a gopher tortoise in the surrounding area:

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Finally, In addition to my partner's slowness I've had to contend with my own. My carpal tunnel's been acting up, which means I've had to take more frequent breaks in my work, hit the ibuprofen more, and make much more use of my wrist braces.

I also started learning the Dvorak keyboard and now pretty much have it memorized. Right now my practice typing (including the start of this entry, up until the checklist) is a lickety-split 11 wpm on a good run.

The Dvorak keyboard is associated with both faster typing (once one gets up to speed) and less repetitive strain. I've been curious about it for decades and only recently learned that most current computers can re-map to it. I now have mine set up so that I can switch back and forth between Dvorak and the standard QWERTY keyboard.

For learning purposes, switching back and forth is generally not recommended (it's better to immerse in the Dvorak), but I think my musical training helps me here, along with this learning system. I've been developing and reinforcing a kinesthetic memory that feels much like learning a new piano piece, from the days when I did that. It's a fun challenge.

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Denise

Hi EJ--I'm so glad to read about the shared hanky during your meeting--not because you both cried but because your partner is dipping her toe (ha!) into the pool of acceptance. That's huge!\r\n\r\nI truly believe your love and compassion has given her the courage to move toward acceptance. Your love of her (just as she is) shows her that she can do that, too.\r\n\r\nWell done. !!