Changes.

It’s been a while!

Hard to believe it’s almost the end of June. There’s been a lot going on in my world, most of it pretty good.

My dad is on the mend from his kidney stone issues and has remained pretty stable with respect to his memory and the Alzheimer’s disease (AD).  Two rounds of infection, two general anesthetics, mild delerium and his memory testing was the same!  Unbelievable really. The thing with AD is that the patient kind of remains oblivious to the reality around him.  He recognizes that his memory has declined but he doesn’t understand anymore the impact it has on everyone else, his wife especially.  If there is any blessing with AD it is that the patient loses their higher executive, frontal lobe functioning early.  It is quite the opposite for the family.  My mom is a strong woman though and she is managing pretty well; she goes to her weekly support group, my brother works from their place once a week and she visits the kids when it gets too much.  I wish there was more I could do for her and for my dad.

As for me,  I’ve done two races this month with decent results, given how awful the winter was with my running.  I have another 10K race this weekend and I am not expecting to do any better than 1:15 but that’s okay.  It’s an opportunity to have some fun, run on the highway and get a cool T-shirt and medal!

I’m starting a new part-time job next month in addition to my family practice.  It is an opportunity I sought out and I am excited about. It is an opportunity to grow as a physician, learn about a different model of care and will be a great change of scenery for me.   I’ll be a lot busier, working 5 days a week (instead of 4) but I think I’m up for the challenge.  The future of primary care in my province is looking hazy right now and I am a little worried. We have been without a contract with our Government for over two years and they are planning on implementing change to how primary care is delivered without consulting the front line workers, ie me!  I felt it was time to start looking at other opportunities where my work is actually appreciated.

I’ve missed the blog.  I hope you missed me too.

 

Facing the Void

My brother and I had a long talk the other day about our parents.  He has positioned himself to be their power of attorney for finances and I am their power of attorney for personal care.  In the past year, it has become evident that we may need to start exercising our roles.   I can’t tell you how sad that makes me.

Growing up, my father was larger than life. He was a tall, formidable man with a deep voice but he was for all intents and purposes, a gentle giant.

Over the past year or so he’s become impatient, occasionally verbally aggressive toward my mom and is forgetting things.  He was diagnosed with mild cognitive impairment last fall but his condition seems to have deteriorated in the last 3 months.  He has a much shorter fuse now and asks my mom to repeat things several times a day.  He denies feeling depressed but we all think he is. Thankfully his family doctor suggested a trial of a low dose antidepressant and he actually agreed.  

He will be having an brain scan soon. I fear it will be normal.  Why? Because the thought of watching him continue down the road of dementia is heartbreaking. It would frankly be much easier if he was diagnosed with a brain tumor. I don’t think I could bear the day he forgets his grandchildren and then me. I don’t think I can watch him become aggressive and angry and frightened at his memory loss.  I see it already happening with my maternal grandmother. 

And there’s the kicker: dementia on both sides of my family? What does that mean for my brother and me? Are we destined for the same end?

We talked about all of it. Dad won’t want to go into a nursing home when the time comes. Will I have to have him declared  incompetent and take over as POA?  If dad moves into a nursing home, mom won’t be able to stay in the condo; will she live with me or my brother or alone in an apartment?  How long are we going to have to watch him deteriorate? He would never want to live like that. I certainly wouldn’t. 

I fear the road ahead.