kitchen table math, the sequel: I miss you guys!

Tuesday, October 6, 2009

I miss you guys!

Well....I'm in Irvington, clearing my head.

I've been so fogged in by fear, grief, and suspense over my mom's health that I can't come up with a proper metaphor and/or clinical term to convey the situation and have been on radio silence. Although I did, during my mom's first ICU stay, acquire the term mentating. As in: Your mother is mentating so well!

I have not been mentating well.

quick update: Since August 12, when my mother fell and fractured her pelvis, she has been:
  • in Evanston Hospital ER
  • in Evanston Hospital CCC (cardiac care)
  • in Evanston nursing home for rehab
  • back to Evanston Hospital ER
  • Evanston ICU
  • back to Evanston CCC
  • in Highland Park skilled nursing care facility
  • in Highland Park Hospital ER
  • in Highland Park Hospital
  • back to Highland Park skilled nursing facility

Has it been 56 days?

I'm grateful I have 3 siblings to help me deal with all this. I just wish C. had 3 (typical) siblings, too.

scared straight

My mom has heart failure.*

She didn't start out with heart failure; she started out with a weight problem, which apparently led to high blood pressure. In middle age she developed Type 2 diabetes, and then, three years ago, she had a heart attack. After that, heart failure.

In short, she seems to be a classic case of what is now called metabolic syndrome.

Of course we kids are horrified not just by the prospect of losing our mother but by the possibility of going through what she is going through ourselves -- and of putting our kids through this, too.

Hence: scared straight.

Which seems to mean becoming a vegan.

When I told a friend that the vegans appear to be right, she said Anthony Bourdain called them a "Hezbollah-like splinter faction" of vegetarians.


* update 7.3.2011: My mom didn't have heart failure. Her PCP thought she did, but she didn't. A year before she died, I went with her to see her cardiologist, who gave us a blank look when we brought up her heart failure and told us she didn't have it. The only reason this exchange took place was that I'd read an article about left ventricular assist devices, and I wanted to know whether my mom could have one. Turned out she wasn't a candidate for a left ventricular assist device because she didn't have heart failure. 

I'll probably never know why we all lived with a fatal diagnosis hanging over our heads for -- how many years? I don't remember. Also, I'm pretty sure the fact that everyone thought my mother had heart failure led to everyone mistaking symptoms of kidney failure for symptoms of heart failure. The extreme pain she was experiencing from kidney failure severely constricted her life and caused the fall that ultimately killed her. 

I know this will sound obvious, but it bears saying: when you're dealing with a parent's health issues, make sure you understand the diagnosis. As I understand it now (and please correct me if I'm wrong), there are two forms of congestive heart failure: chronic and acute. It's entirely possible that both my mother and we kids were told that she had the acute form and no one explained the difference.

It's also possible she was misdiagnosed -- or that she was correctly diagnosed by her original cardiologist, who left town, but there was some kind of miscommunication with the PCP.


Catherine Johnson said...

I can't say C. has greeted the prospect of steel cut oats for breakfast with enthusiasm.

This weekend I showed Jimmy a bowl of steel cut oats.

"Say no! Say no! Say no!"

Crimson Wife said...

My aunt's husband has a very strong family history of cardiovascular disease and has survived 2 heart attacks. For several years was on the Pritikin Diet (which I believe is vegan) but he's now eating fish twice per week. FWIW, his numbers have improved since he added seafood to his diet.

Allison said...

Might I suggest that now is NOT the time to be making any lifestyle changes, as NOW is filled with bad mentating?

uh. Interesting that veganism is the answer, supposedly, particularly because the type II diabetes diets are largely atkins-like: heavy on the carnivore, light on the fruits and grains. Almost the direct opposite, in fact.

Your mom made it back to a nursing facility? YAY! Is there anyone there to visit her?

Amy P said...

I'm sort of a diabetes groupie (a Russian friend has Type I and I've traipsed along to lots of endocrinology appointments to make sure nothing important got lost in translation) and Allison is correct--a diabetic diet is very light on the carbohydrates. I remember thinking at the time that the recommended diet sounded very Atkins-y. I should mention that ketone poisoning (a chemical byproduct of fat being broken down when the body is unable to access glucose) is an issue for both diabetics and Atkins dieters.

Tracy W said...

Oh dear, my sympathy for all the stress you're going through.
And remember that people recommend all sorts of weird things about diet.

Anonymous said...

I'm with Anthony.

And Amy and Allison...

Hey, we're thinking of you. I'm glad she's back at the nursing facility.


Catherine Johnson said...

Hi you guys!

Susan S -- I'll be back!

(Coming back next weekend.)

Catherine Johnson said...

Crimson Wife - that's interesting.

Pritikin is vegetarian?


I'm semi-new to all this stuff.

oh.....sure enough.

Yup: there's that 10% fat figure.

You have **no** idea how difficult it is to hit 10% fat without actually being a native.

Catherine Johnson said...

Interesting that veganism is the answer, supposedly, particularly because the type II diabetes diets are largely atkins-like

That's what I always thought (& that's why I was drawn to high-protein diets.)

Turns out there is debate on this issue as on every other issue, I gather.

Neal Barnard seems to be the leader of the contrarian camp:

Barnard ND, Cohen J, Jenkins DJ, Turner-McGrievy G, Gloede L, Jaster B, Seidl K, Green AA, Talpers S. A low-fat, vegan diet improves glycemic control and cardiovascular risk factors in a randomized clinical trial in individuals with type 2 diabetes. Diab Care 2006;29:1777-1783.

Barnard ND, Scialli AR, Turner-McGrievy G, Lanou AJ, Glass J. The effects of a low-fat, plant-based dietary intervention on body weight, metabolism, and insulin sensitivity. Am J Med 2005;118:991-997.


The vegan diet Barnard prescribes for diabetic patients is:

10% fat
15% protein
75% carb

Catherine Johnson said...

I'm not going to be able to reproduce this line of reasoning....but I gather that Joslin was the physician who developed the theory that the reason diabetes is so deadly is that blood sugar is too high; hence the solution is to reduce blood sugar levels via insulin and diet.

I **think** (but don't quote me - this is entirely from memory) there is a group of researchers who question this conclusion.

I'll have to remember where I read that....

Catherine Johnson said...

Your mom made it back to a nursing facility? YAY! Is there anyone there to visit her?

Her best friend is there & we're all flying in and out ---

Catherine Johnson said...


My mom does not have heart failure.

Complete & total misdiagnosis, which we all lived with for years.

She has diabetes, which led to kidney failure.

As best as we can determine, we interpreted symptoms of kidney failure as being symptoms of heart failure.

However, she was indeed told by her primary care physician that she had heart failure.