The Boss

While we go through ups and downs with our kids and my parents, it's comforting to have the daily routine of taking care of the chickens, ducks, geese, and rabbits, and preparing the garden for winter.  There's always something happening and it's always interesting.  Sometimes it's entertaining, too.

Today I heard loud squawking and looked out the window just in time to see our miniature rooster, Napoleon, pick a fight with our giant goose, Augustus.  Napoleon loves to assert his authority.  Whenever we go outside, he insists on accompanying us, just to make sure we won't do anything to threaten his hens.  Maybe he wants to make sure we know who's boss.  He will perch on the fence right next to us then proceed to crow loudly, two or three times, just in case we didn't know he was there.  He's not the loudest rooster we've had, but when he is less than three feet away and on the fence, which is ear level to me, it's startling, to say the least.

If he's on the ground without a high perch close by, he will inevitably go into attack mode.  He goes for our shoes with a vengeance.  Most of the time, we experience this as "something just bumped into my leg", and instinct kicks in, literally.  I'm afraid that Napoleon has gone on several short trips flying backwards after my leg shot out, unintentionally, at his first attack.  Never one to give up after the first go, Napoleon comes right back for more.

He reminds me of the chicken hawk in the old Foghorn Leghorn cartoons.

He got more than he bargained for today when he picked a fight with Augustus.  With wings flapping, he jumped at the goose, over and over, with claws out.  Augustus simply bent down and picked up Napoleon by the feathers on his back and stood there, holding him, while our little rooster protested and kept on trying to get at the goose with his claws, wings, and beak.  Haven't I seen something like that in a cartoon?

I didn't let it go on.  Augustus is incredibly strong and might have hurt or even killed Napoleon, without meaning to.  I ran outside in my bedroom slippers.  This sight alone must have startled Augustus into dropping the rooster.  Whatever it was, the goose was content with letting go.

Napoleon, however... that was another story.  He puffed himself up, mortally offended that I had come to his rescue.  He looked at me as if to say, "I was doing fine.  I almost had him there.  Why'd'ya have to ruin it?"

I suggested to Napoleon that he might be a bit more grateful.  I had just saved his life, after all.

He pretended to ignore that comment and glared at me sideways...

until I turned to go back in.  That's when he attacked my slippers.

We know who's boss.

When is Dementia not Dementia?

Modern medicine is amazing.  I know that first hand.  As much as I respect and prefer natural and homeopathic remedies, and a holistic approach to medicine, I also know that modern medicine can be nothing short of miraculous.  I take a miracle drug called Sinemet.  When I take it regularly, I can walk, talk, breathe, and move, in a relatively normal manner.  If I am without it for a full day, all of those tasks are more difficult for me.  In fact, walking is not possible.

I also know that modern medications can cause as many complications as they cure.  That is why we look to the doctors to tell us what medicines to take.  They are the experts, or should be, anyway.  Sometimes they get it pretty mucked up.

For the last year, we have been helping my parents cope with my mom's diagnosis of vascular dementia.  She has had major ups and downs, times when she didn't realize what city she was in and thought my dad was her older brother, George.  Sometimes she packed her paper bags and purse and demanded to go home, even though she was already at home.  This sounds like typical dementia.

I wasn't totally convinced but I trusted the doctors' judgment.  They've had experience with many patients with dementia; they ought to know.  What confused me was that Mom could remember many details about conversations that she'd had over the previous week.  She could remember what was coming up in my schedule and remind me about it.  She might not know what town she was in or what year it was, but she knew that I was going to the eye doctor the next day.  This does not sound like typical dementia.

An attempt to convince our parents to go to geriatric specialists didn't go over well.  They had gone to their doctors for years and that was that.  At last, things progressed beyond what we could handle without support and we were able to sign both our parents up for Total Longterm Care, a managed Medicare/Medicaid program. 

This has truly been a blessing.  Their new doctor, Dr. Pham, is a geriatric specialist and the first thing she did was to meet with a pharmacist and go over all of the medications that my mom had been taking.  They made a number of changes.  I had the opportunity a couple of weeks later to talk with a psychiatric nurse practitioner, who confirmed the importance of the changes that were being made.  The previous combination of medicines were, according to this nurse, a "recipe for delirium". 

This means that we don't know whether Mom really has dementia or whether her confusion issues were solely due to the medications that had been prescribed to her over the last years.  Mom has been clear and not confused at all over the last couple of weeks. 

Our new challenge is the withdrawal symptoms she is experiencing after going off certain drugs.  She is extremely anxious, nervous, shaky, and at times, she goes through deep depression.  She is still on medication to treat these symptoms; however, until some of the old drugs clear out of her system, there will be some withdrawals.  She understands what is happening and, though she sometimes says it would be easier to be confused, she is determined to get through this challenge.  At least, she was more determined last night than she has been so far.  It continues to be a day to day battle.

We've all learned a lot.  Doctors are good but not infallible.  It's important to ask questions and to seek another opinion, especially when you are taking a lot of medications.  At 81, going through drug withdrawals is hell.  I keep telling her that this will be worth the effort.  She might just buy some time to actually enjoy life for awhile. 

That would be an incredible gift.