Today was an interesting visit with Bill. Because of Hurricane Beryl and my resulting trip to Austin, then New Jersey, I had not seen him for over 3 weeks. This is the longest time we have been apart since I placed him in Memory Care. I wondered if he would notice.
When I arrived, he was nodding off in the Living Room area of his POD. He recognized me right away, so that was a good start. I asked him if he wanted to go for a ride and get some lunch. He smiled his usual, big, "smiley face" grin and said "yes!" As usual, I suggested he go to the bathroom before we took off. We did have some troubles there, but after the aide cleaned up, off we went. It did make me a bit nervous he was going to have a 2nd round of troubles, but we lucked out.
We rode around for awhile, ending up at his favorite steak place, Texas Roadhouse in the Baybrook Mall, only to learn it did not open until 4pm on Mondays. So, we gassed up at Sam's next door and then headed back up towards Houston to House of Pies. I noticed him twitching his arms a couple of time, but I ignored it.
We had a good lunch and dessert. All was well other than he wanted to discuss an extremely odd idea he had about "poop stations for people." This was one for the books! It was most likely brought on from his incontinence earlier in the day, so maybe it's not as strange as it sounds. Alzheimers patients lose their "filter" and also the ability to use the right words, so he was probably telling me they need more places for people to go so they don't have incontinence issues. It made sense to him and I told him it was a good idea.
Then he began twitching his arms again. I had not seen this behavior in him before. When we returned to the VA, I told the head nurse about the twitching. She assured me she would have the doctor look into it. Meanwhile, I took him back to his room where he promptly fell asleep in his wheelchair. He was exhausted. I sat in his cozy recliner and answered email while he slept. When he awoke a short time later, I told him goodbye and started back home.
Not once did he ask where I had been for the last three weeks or about the hurricane. It was like I had seen him yesterday and the hurricane never happened. So now it's confirmed: No matter how long I'm gone, he has no idea how long it's been. To him, it's like I was there yesterday. That's a good thing.
When I got home, I looked up "Alzheimers and twitching" on the Internet. I discovered "twitching" could be a side effect of Memantine.* Memantine is prescribed to delay the advancement of Alzheimer's disease. So which is better? Delay the advancement of Alzheimer's and twitch, or get off the medication, not twitch, and advance to the Stage 7 sooner? Definitely something I need to discuss with his doctor.
Of course, it could be something else altogether. As my daughter often asks me when I try to self-diagnose and prescribe, "Where did you get your medical degree?" I probably need to get my doctor this mug - LOL!
*Memantine-induced Myoclonus in a Patient with Alzheimer Disease, a study by Aditya A. Murgai and Mark S. LeDoux
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