Exhausted.

Today started badly and then went into a spiral from which there has been no escape. Rama resents my going to the gym early in the morning. (I go at 6 because she is still in bed and sleepy so that the chances of something going wrong are limited.) when I got home she was reading and quietly ignored me. OK, fair enough, but then there began the pitying complaints about pain and the accusations that I was responsible because I went out.
We had a busy morning schedule: had to be at the Strong clinic by 10 so showering, dressing etc needs to move at a pace. I could see Rama internalizing all her resentments and tension as she so often does. There is no way around this state of mind so I ignore it. Result: on the way to the hospital Rama was car sick, throwing up all over her shirt. Luckily the hospital gave us a gown and she completed her program commendably. I got to clean vomit and deodorise a smelly car! By the time we came home the black cloud still hadn't lifted but we ate lunch peacefully.
By the afternoon Rama was loudly complaining about pain and not listening to anything that I said. We went to the doctor who increased her pain medication patch and referred her to a pain clinic. Again, at home Rama could best be described as howling and angry. I couldn't cope any longer and left her in the lounge to howl while went the other end of the house and shut the door.
After a few loud yells she settled down and dozed. Later I told her that I wasn't angry, just exhausted and couldn't cope anymore. She understood that but she is still intensely unhappy and discontented. I'm wondering if she is suffering from depression because it seems that some of the tears are pain induced but others are not.
Got her to bed and dozing at 9 and I hope that she has extended  periods of rest and doesn't get up every 20-40 mins to go the toilet as she did last night.

Ups and downs

Today is definitely tough. Rama woke at 3a.m. whimpering with pain in her arm. This is par for the course with experimenting with pain management. She had been using pain relief patches but these needed to be supplemented with Endone, which the doctor wanted to phase out. When she got to 15mg patches but still needed Endone the doctor said that obviously her system needed Endone and the patches were not effective so he started the process of withdrawal. (They are addictive, being morphine based) so now Rama is using a 5mg patch and I think that it is telling on her system because by the early hours of the morning her pain relief has worn off. Now I'm in a quandary: do I reintroduce the patch to provide all night relief of let her system adjust?

Either way, this morning has been hard going and it's only 10! Lets see how the day unfolds.

The more things change...

Rama woke up this morning screaming with arthritis pain. Nothing psychosomatic there. After Endone, she was off to her Strong (rehab/physio) program which she did well, considering the limitations caused by the pain and arthritis.

Since my last post I've noticed that frustration is building in both of us. This is centred on communication, as you might expect. Rama is also quite cantankerous about the pain from her osteoarthritis in her right arm and spends a good deal of her time complaining about discomfort. There is no doubt that the pain is at times fierce and eye wateringly agony but at the same time I think that she allows herself to dwell on pain and imagine it to be worse than it is. Boredom is the key here:  she has too much idle time to ruminate on her ills.

This has led to some horizon lighting storms at home as the two of us battle each other's will. Much of this is related to the administration of pain killers. Our doctor has recommended using a patch which releases a close cousin of morphine into the system continuously for 7 days. It takes time to get the dosage right and this is the issue. We started with a 5mg patch which was useless for pain relief and have crept upto 15mg but Rama is still demanding Endone tablets. She does need these occasionally when there are pain spikes but she insists on taking one every 4 hours which I'm resisting. I think it is psychological in that she equates the tablet with pain relief but doesn't really believe that the patch will do anything. I suppose it's a tactile response: take a tablet and pain is relieved. Do nothing and pain stays.

The battle will continue but it is wearing. We'll see the doctor again this week and possibly up the patch dosage to 20mg.

I have tried diverting Rama's attention away from the pain but with limited success. Somehow I've got to get her past the idea of swallowing a tablet as the solution to all her ailments.

28 January 2013

Everyone says that you learn something new each day: it's a time worn cliche but true nonetheless. This occurred to me at about 1o'clock this morning when Rama woke me with her whimpering and crying. At first I thought that she was desperate to go to the toilet but it turns out that she had pain in her back and left leg. There was no apparent reason for this: no falls or twists, she just woke up with it.

But how do you find out what's wrong with someone who cannot speak? How do you determine the level of seriousness? How do you work out what are her appropriate needs? It was these questions that prompted this blog. I'm not seeking answers because I'm not sure that there are any but I need to explain what's going on in our lives in order to for life to make sense to me. 

I'm not sure how to structure this blog either, but the thought occurs to me that I ought to go back 7 months to the beginning of this saga to give some perspective, both for readers and me.