My french GP.
Thank you
Good bad and possibly worse over the past week or two.
Firstly, I managed to get her into a rhythm as regards eating. Porridge in the morning with a prune as sweetener but also because her bowels werenât moving for days on end. Followed by Fortimel or equivalent.
In the evening a pure baby food followed again by Fortimel. After a couple of weeks she put on a kg to 31.
Then, although there was no diarrhea, I was having difficulty cleaning her after going to the toilet. This was because no matter how much I did so there was always more and I remembered her telling me back in her care home working days how some of the confused residents performed a âmanualâ, as she and her colleagues called it, and you can imagine the mess that got them into. It never seems to end, it is like a cross between diarrhea and constipation, a lot there but which wonât come out. I was tempted to phone Christine for advice but didnât like to trouble her off, or on, duty. I used 10 toilet tissues and 4 wet wipes and the flannel glove that I wash her bottom with. I had to put her, backwards, onto the bidet but was alarmed at what I was putting down its plughole, not what is supposed to go, that is for sure. It would be the same if I could get her into the shower, although I donât do that, too much risk of us both falling so I leave that to the professionals. I think in future I will have to wash her at the sink, if she can stand long enough, and just put up with cleaning the floor afterwards.
Today, another trial to add to the mix. I got her up, cleaned her again even though she hadnât left anything in the toilet and stood her at the sink to wash her face and upper body and then, as usual set her up with the loaded toothbrush while I did some other things in the kitchen. When I came back I saw her legs buckling and got there just in time to stop her falling. With both hands and arms full around her waist from behind I dragged her to the bedroom but couldnât get her on the bed because it was too high (I use it to support her upright when I get her out). I managed to drape her forward onto the bed and got her to hang on to the bars while I made a dash for the wheelchair. Jamming it hard up against the bed I managed to drag her onto it, squirm her round and finally get her settled. It was very close to being a pompier job though. Knowing I would not be able to lift her if she went all the way to the floor I have been told more than once if that happens, not to try but ring 18 immediately.
It is Gill, the Scottish aide and ex-nurse that is coming in on Monday morning so I will seek her advice. I should emphasise that Fran was not collapsing in the sense of fainting, simply that her weakened knees started to refuse to take her weight.
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Just a thought David. My father in his final illness had no muscles in his bowels to push, so he too used to âhelp it outâ This was solved by a weekly (maybe twice weekly) visit from a nurse who gave him an enema. meant it was all better controlled. Could Fran have the same?
Yes, that is what Fran meant by a âmanualâ, and that is the problem, her muscles are not strong enough to push, and maybe that is what Gill will advise on Monday. The aides de toilette come twice a week and the aide domicile, which is one of them sometimes, once.
We are supposed to have 3 plus one but I suppose that they canât get the staff. The ones that get her out of bed and to the bathroom only have an hour and it is always a rush. The domicile one is here for 2 hours and is more than enough (though I am not going to tell the office that 
) and they have time to talk to me too, which I have learned is part of the job, and I do appreciate it.
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As you know we have been through very similar with my mum and the legs buckling may just be the brain not sending the right messages. My mum now needs two people to get her in and out of a chair. Etc etc. So although this is probably a grim thought, have you thought about what you will do going forward ? I suspect that Fran will need full time care within the next three to six months. Sending love and empathy xx
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Thank you Cat, yes I have thought about what I will do going forward and the only answer that comes to me is to carry on as I am doing. But this latest developement has rung a warning bell.
Fortunately her weight is so low that I can lift her from bed to standing (with the aide of the rising medical bed) and from chair to standing and back again, also the toilet. But all these actions depend on her being able to take her own weight on her legs as long as the knees are locked. But Thursday was a salutary warning that all this may not be possible soon.
The other worry is her fragile bones. All I could think of as I caught her and dragged her yesterday with my arms firmly clamped below her rib cage was whether or not I would break or dislocate bones again. If I had not caught her at that point but higher under her armpits it would have been game over and a call to 18.
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This thread has made me have renewed enthusiasm to do my pilates. Got to keep those pelvic muscles strong!
So sorry this is progressing like this David, and hope you can have a good talk with Gill. Itâs hard, but I think you need to anticipate next steps.
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Yes, despite our differences, a result of her abrasive attitude in comparison to mine of permanent sweetness and light, 
as an ex nurse she will have useful input. Only trouble is that with having to get Fran up, transported, toiletted, showered, dressed and sat down ready for breakfast, all in one hour, there is never any time for useful conversation.
Although mainly Christine, they both tend to shut the bathroom door when in there with her, for warmth they say, but as the bathroom is as warm as the adjoining kitchen, heated by both air to air fan and sometimes sunlight, as long as the door is open, that cuts down even more the chance to talk. But I will do my best in the morning.
Like you (although I thought pilates was something to eat 
), I do recognise the importance of my own fitness, so little stops me from my daily dog walk, trike circuit and swim. 
I think itâs well known that nurses are the worst patients !
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A bit like professional lorry drivers being terrible passengers. I know I am, it terrifies me without control. I only ever rode once on the pillion of a motorcycle, Never again, I was convinced I would be swept off the back with the velocity if I once stopped my desperate attempt to break his ribs with my arms grasped round him.
I will tolerate buses, just, will never again ride in an aeroplane, and feel strangely comfortable on a train even though I know that whoever invented a method of transport which will travel at almost the speed of sound (or so it seems) yet expect it to stop by putting one strip of steel on another, must be stark staring mad.!!
Well I hope that it is well known enough by now that my posts on this thread give fair warning that the contents are not for the faint hearted and thus can be avoided. But I will be as gentle as I can, just as I have been for the last hour and a half with Fran.
She was actually losing solids on the toilet before bed but to avoid the horrors of the previous 3 nights I stripped to the waist and worked out how to complete her task for her while still on the toilet.
Arming myself with a useful empty plastic container (Dash blisters for the washing machine), an old packet of wet wipes (not so wet now) the toilet roll and the flannel glove, I decided to try and reach behind her but needed to be to her right so that I also had access to the wash basin. I then found to my surprise that my right handedness worked for us as I stood facing the wall, much easier than the way I have been doing it.
I can hardly believe the amount of âstuffâ that I removed. First with the toilet paper (at the very least a dozen sheets) dropped straight down into the bowl, then with the wet wipes carefully folded and dropped into the container, and finally with the flannel glove, shaking it where possible before removing solids with a wet wipe then rinsing it thoroughly under the wash basin tap. All this time she was screaming in agony and I could see why, at one point I thought what I was feeling were haemorrhoids, but they werenât.
Finally the flannel was merely stained and I brought her to the basin to wash her with soap on it, then rinse and finally dry with a kitchen towel.
We have learned a lot tonight, not least the fact that instead of getting her to sit in order to put her pants back on we have at last found a use for the walking frame, not used for a year since the fall which made her left arm almost useless. Now she can stand in it with her bum resting on the front bar and can assist in taking her weight by straight-arming onto the handles, long enough for me to lift first one then the other foot to dress her.
An hour and a half, over a dozen toilet papers, half a packet of wet wipes 4 kitchen towels and 3 or 4 flushes of the toilet, but we begin to see the light. Advice will be sought from Gill in the morning and when I go to the shops I will either get a prescription from the surgery or book the doctor to come out to her, he tells us every time that he is willing and able to do home visits as we are so close.
Despite the grim reading above I think a 
is in order.
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Thank you, not always so cheerful though.
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Oh dear, Gill the Scottish Aide has just come through to me to say that Fran is refusing point blank to leave the toilet and go to the shower. As requested I have been through and had a little chat to her. Listening from the other room as I am now, it sounds as if she might be going. 
I hope she doesnât tell her to âpiss offâ as she did to Patti when she was saying goodbye. 
On her arrival I had a brief talk to Gill bringing her up to date on the events of the past 4 days and she agrees that the best course is to get the doctor out and probably give us a prescription for the relief/prevention of constipation.
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David you are doing so well in caring for Fran.
We visited a friend in Stoke Mandeville who is paralysed after a fall. Part of her daily âpersonal careâ is for the carers to evacuate her bowels. Is there someone in the cate team who are experienced in this and can help you with the technique?
Probably is Nici, but it is the lack of time that would probably hinder that. As it is, because of the slight contretemps with Fran this morning, Gill was 10 minutes late in leaving which no doubt knocks on for the rest of her day.
But Christine is scheduled to come on Thursday and I will remember to ask her.
I have been to the surgery and told to come back for the laxative prescription at 2pm, the current one having expired, without a rdv with the doctor. That might ease the situation.
Did that but then was told to wait while the doctor saw his rdv patients first. No time for that, so called in at 5.45pm just before closing time and there was a roomful of at the very least 20 people waiting for non rdv consultations.
I could understand it if I was Fran, and not just the messenger, and he had to see me before writing a script, so I left empty handed again. As every time we have vistied him on a rdv he has urged us to have a home visit that is what I did in the end and he came on Monday morning, gave here a complete examination, while Gill was there, and gave me the ordonnance. Only trouble with home visits is it is written not printed and the pharmacist had to ask me what it was because he couldnât understand it. Luckily I had the previous, printed but expired, one with me.
Tomorrow is our next scheduled visit to the geriatric doctor, Dumas, in Perigueux. I am sorely tempted to ring and cancel as there is nothing he can do for her but, as the last visit proved, he was more concerned about me and my sanity, so perhaps we had better persevere. 
The powers that be have decided that we need more visits and longer hours and have sent me a form to send back along with our tax docs, so that has been done. But I know how short staffed they are so am not holding my breath, before all this started we were authorised 3 visits by the Departement and have never had more than 2. That is for the health visits of course I am assuming the cleaning ones will be unaffected, though I would trade that for more hours if it were necessary. Cleaning the house is much easier for me than dealing with Fran sometimes.
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Donât think of cancellingâŚ
I really do hope this appointment does prove worthwhile⌠whether it be for Fran or for you⌠or both.
good luck
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Thank you, weâll go.
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