Saturday, July 30, 2016

Beautiful Wedding!

The wedding was last night and it was beautiful ... long, but beautiful. I guess I have never been to an Episcopal wedding before because I do not remember being at such a long wedding. And they tricked me! Actually, they tricked Soliel and me! They asked us to be witnesses; what they actually meant was maids of honor. And since the minister was Native American, there was also a blessing of the robe and smudging - we had to hold the blanket behind them at the start of this part of the ceremony. Yes, the 2 shortest people in the wedding party had to hold up the blanket! But we did it, we fulfilled our responsibilities to the happy couple! Here they are at their first dance.

And here they are with their daughter Mary, singing a special song for their first dance.

The whole experience was very special. Since U. S. law did not allow them to be married until recently, they were in a committed relationship for 17 years and raised a bunch of kids together. So the kids were a part of the ceremony and did some very special things. Mary sang at both the wedding and reception and Kat made the blanket and Mary Kay's jacket. Kat and her husband Matt hosted the rehearsal dinner and Kat did all the cooking for a Korean dinner. Here's Kat in action.

CONGRATULATIONS to Anne and Mary Kay!

Wednesday, July 27, 2016

Tidying Up Loose Ends

The main reason for my trip is to attend the wedding of my friends Anne and Mary Kay. A secondary reason is to tie up loose ends from my move. Like updating the Subaru registration to include Kai - who was 5 years old when I originally bought the car; updating the car insurance to delete the Volvo we donated for KSER; moving funds from my Washington credit union to my Hawai'i credit union; etc. We did some of that today, more to come tomorrow, and in following days.

I am staying with Bick and Ron; we called Mom tonight just for them to say Hello. It's great that she remembers them and Bick's mom very clearly. However, she does not remember that I have moved back to Hawai'i permanently; she thinks I am up here still trying to sell the house. It was unclear to me when she thinks I am coming back from this trip.

Speaking of the house, Kai and I drove by today and saw a 'For Sale' sign out front but no flyer showing off the improvements. The birch tree that provided great shade for the front of the house has been cut down. (I had even explained to them how having it kept the house much cooler in the summer. The folks who bought the house must not like trees. I wonder if they are the same ones that bought the house at the end of the alleyway on Wall and cut down that really nice Douglas-fir tree just before it was put up for sale?) I don't think they did any of the interior work they said they were going to do and I don't think they could have done all that in less than 6 weeks. To replace only Mom's shower took 6 weeks; and they were talking about remodeling the entire bathroom, not just the shower. They also talked about removing all the carpet and old linoleum and either replacing it or refinishing the floor if they found nice wood underneath; replacing the paneling in all the downstairs rooms; replacing all the old countertops in the kitchen; removing the sheetrock in the upper level and the insulation that had been put in incorrectly and replacing it and refinishing the ceilings; and there was a crack in the foundation that needed to be repaired.

I flew on Delta this time since my original flight was to be with the rest of the crew returning to Washington and they initially flew on Delta. Here's the display you get with Delta in multiple languages. Another 'selling' point for some people is that all the entertainment is free - Kai watched Zootopia twice on the aborted flight to Kona, once on the way out and then again on the way back!

I like the bathroom signs at the Honolulu International Airport - they're very colorful.

Happy Birthday to Rachel! And Happy 3rd Anniversary to Eleta & Trish!

Monday, July 25, 2016

Multi-Birthday Lunch

Took Mom in for another blood test; we did not hear anything today so it must mean she has not reached the threshold for getting another transfusion. I was expecting that she would since she was complaining of being more tired and she also was short of breathe a couple of times in the last few days.

After the lab we went to lunch with cousins Erica and DeeAnn (both from the Hilo side of the family) at Gyotaku Restaurant. The walls are covered with beautiful prints made using real fish as the printing surface = gyotaku. The food was great and so was the company! Here's Mitchell playing with Dory.

There were 3 birthdays being celebrated: DeeAnn, Fumi-san, and me. Are birthdays are less than a week apart.
L to R: Mitchell, Erica, Mom, Fumi, DeeAnn, me; last 3 are the July birthdays!

We had a conference call with Mom's estate attorney this afternoon. I think she feels much more at ease that things will be taken care of after she passes. Everything in the Trust they set up will go to Dad. We just have to make sure everything is in the Trust! After I return I will be working with her to meet with the people administering her investments to close out the accounts and put the proceeds in to one of her savings accounts. She seems pleased that it can be done relatively easily and rapidly.

Shiro caught a cricket that was in the house. It was a female which is why we did not hear it chirping earlier.
Follow Shiro's ears to see where he is focused to find the cricket by the wall.

Happy Birthday to Jesus, Margie, and Darin!

Sunday, July 24, 2016

Mahalo, Mauna Kea!

Tropical Storm Darby made landfall yesterday on the Big Island near Pahoa; near the same place Hurricane Iselle made landfall in 2014. After plowing through Pahoa (but doing less damage than Iselle) Darby ran in to Mauna Kea; at nearly 14,000 feet tall it took a lot of power out of Darby and deflected its course. (It did the same thing to Iselle.) Earlier forecasts showed Darby hopping from the Big Island to Maui County to Moloka'i to O'ahu to Kaua'i. But after leaving the Big Island, Darby kept heading mainly westerly, and well south of Maui County, Moloka'i, and O'ahu. It has been raining on and off all day, then at around 6:30 pm it began to pour! Nearly 2 hours later it is still raining buckets along with lots of thunder and lightning; won't have to bother with watering the plants tomorrow! Here's the rain coming off the neighbor's roof at about 6 pm, before it really started raining. Note the poor little bird perched on the lights at the far corner taking refuge under the eaves.

I took Fumi-san shopping for groceries so she can cook all kinds of yummy Okinawan dishes for Mom while I am gone. We went to the Marukai Market Place which she prefers over Don Quijote. When we got back from grocery shopping we saw a bird sitting in the garage under the other car. It ignored us as we drove in and looked dazed. I later caught it; it is a spotted dove and is missing the primaries on its right wing. Perhaps it was being chased by something that managed to grab its right wing before it plowed in to the living room window. I dropped it off at the Humane Society. I found out they are an open admission facility and will take any animal, domestic or wild, native or non-native, injured or healthy. And they're open 24-hours a day for admissions; even with an approaching tropical storm! (The Adoptions side was closed due to the approaching storm.)
Injured Spilopelia chinensis

I finally got around to taking a photo of my July calendar. My good intentions to do it earlier in the month got side tracked by the emergency room visit, the trip to the Big Island, and a house full of family. I should be able to do better in August since I will be back from traveling on the 4th and family won't arrive until the 17th.

Happy Birthday to Shirley! And a big congratulations to Darla and Jim on their wedding today! (Sorry I could not make it there.)

Saturday, July 23, 2016

My Turn Today

Well I am finally at the ER for me! Last night my left ear canal was hurting a little when I went to sleep (1 on a 10-point scale). This morning I had a sore throat (3) and my ear was hurting even more (3); my lymph nodes on the left side were also swollen. So rather than wait 9 days like Kai did, I went in this morning.

The diagnosis is "inflammation of throat - primary, middle ear infection with fluid accumulation". And although the ER doctor said most sore throats are caused by viruses, like Kai's ER doc he prescribed an antibiotic for me due to Mom's compromised immune system. (He did not speculate on the cause of the ear infection, which I think should have been listed as 'primary'.) While waiting for the prescription to be filled I had company. This was at one of the tables at the coffee shop which is closed on the weekend. I think these birds are regulars. This zebra dove especially, it's differently-abled; take a close look at its toes, or rather, lack of toes.
Differentl-abled Geopelia striata

In order to minimize chances of Mom becoming infected by whatever is causing my ear infection I am staying in my room as much as possible, when I venture out to other parts of the house I wear the anti-virus mask and sanitize my hands. I also sanitize my phone; its a good thing I have the LifeProof case! So far it has shown no ill effects of being slathered with hand sanitizer. It cost around $80 but I destroyed four $30 Body Glove cases for my last phone so in the end the LifeProof case is more cost effective. (I was also sanitizing it  when Mom was in the emergency room and hospital before we knew what she had.) Now if we can only get Mom to understand that she should not come to my room, or if she does she needs to be wearing her mask!

It is a good thing Mom's friend Fumi-chan is here visiting from Okinawa and that she is staying for several weeks. While I was at the ER this morning she made breakfast for Mom and Dad and kept an eye on them while I was gone. (Unlike last week when Kai was in and out in a short time, I spent over 3 hours there. I was fortunate to be seen almost immediately, but then had to wait for the discharge papers and prescription as they were swamped with patients, I saw at least 7 in the half hour after I was admitted.)

I think the benefits of the transfusion are wearing off. When she came to my room to tell me dinner was ready Mom was breathing hard. Not gasping for breathe like the first day when I took her to the emergency room, but too out of breathe for the short walk down the hall. I guess we will see if my assessment is correct when she has her blood work done on Monday.

By the way, at this time in the evening the ear canal pain is 0 and the throat pain is 1. When I told the ER doc this morning that Kai started feeling better a couple hours after he took the azithromycin he said that antibiotics don't work that fast, they take 2 days to begin working unless the individual has a fast metabolic rate. I think Kai and I must have fast metabolic rates because I think it is the antibiotics that are responsible for my improvement; the only other things I have done are wear an anti-viral mask and sanitize my hands!

Happy Birthday to Bev!

Friday, July 22, 2016

Tropical Storm Darby

The hurricane season in Hawai'i is from June 1st through November 30th so it is the season. So far there have been 8 storms that started in the eastern Pacific and none in the central Pacific (where Hawai'i is located). Sometimes storms that start in the eastern Pacific make it to the central Pacific, like Tropical Storm Darby, which is about 180 miles east of Hilo (or about 390 miles east of Honolulu). Darby is the first storm of the 2016 season to get close to the islands and as of 5 this evening, the forecast track takes it right over the top of the islands of Hawai'i and Maui, and slightly east of O'ahu. The cone shown below is not the area of potential damage, it is the predicted possible area it could travel in. Obviously, there is still time for the track to change. Sometimes going over Mauna Loa, Mauna Kea, and Haleakala greatly affect hurricanes and tropical storms, causing them to lose wind speed. At a minimum Honolulu will have a lots of rain and hot, muggy temperatures. [NOTE: Apparently the link below is live and updates everytime my blog is opened. So what you see is not what I was looking at when the post was originally written.]

5 Day Track for DARBY

Mom's reaction to news about Darby has been interesting. The Big Island will be hit first sometime on Saturday afternoon so there are all kinds of preparations being made, including opening emergency shelters. One of the shelters is the Kohala High School. When she saw that she asked me if we had enough water and food for the storm (because that is what the newscast was recommending for people on the Big Island). She thought we were in Kohala. The storm will hit Honolulu late on Sunday, if anything. And, yes, we have enough food and water; that is the standard condition of Mom's pantry. I have emergency lights (from years of living in rural Washington). The only thing we don't have is my emergency radio, which is packed in a box in transit to Kohala.

I have noticed Mom is a little more confused as to who people are and I am wondering why they took her off the donepizil. I shall have to ask about this. Yesterday she was trying to figure out who was still at the house and said, "Dad, me [meaning herself], and Pologee." ("Pologee" is my father's nickname that was given to him at boot camp because the white drill sergeants had trouble pronouncing our last name so shortened it to "Nobriga" which is a Portuguese name. It is pronounced 'poh-roh-gee'.) The "Dad" she was referring to is her father. I was nowhere in the picture of who was still at the house. After a couple of minutes she corrected herself and figured out who was really here (including me). I will have to ask if she can remain on the donepezil so that she can enjoy visiting with people who come to see her.

Mom's friend Fumi-chan arrived today. She used to live in the back house next door but in early 2014 her Aunty Nancy, whom she was caring for, passed away and she had to return to Okinawa. They have been keeping in touch by phone. The last time Fumi-san called, Mom and Dad were in Las Vegas; I told her to call back on Saturday. While I was sitting in the emergency room with Mom I realized that Fumi-san was to be calling that day, but there was no way I could get a message to her! Fortunately she was persistent and one of the times she called she talked to Curtis, so she knows what's happening with Mom. When she lived next door, she would always bring food over when she cooked for her aunty. Mom has asked her to make a couple of things while she is here and I have asked her to teach me how to make them!

I finally finished doing the last batch of sheets and towels that Aunty Florence and crew were using. Since the weather was nice I hung everything outside. When I was hanging laundry yesterday I felt something on my foot and thought it was a stalk of grass. It turned out to be a brown anole. (Sorry, no photo, phone acting up again.) They showed up again today. It appears that when I walk across the lawn hanging the laundry, I stir up bugs so they have learned to come around when they see the activity. Sort of like cows and cattle egrets. Here is one using the leg of the laundry cart as its hunting perch.
Anolis sangrei

Happy Pi Approximation Day!

Thursday, July 21, 2016

All Quiet Again

Aunty Florence, Justine, Ursula, and Kai left at about noon today. There were no malfunctioning planes this time so they made it back to Seattle with no incidents. And now the house is quiet, Mom keeps forgetting who actually came to visit. The cats have calmed down and come out of hiding, except for Shiro who let the girls hug him and play with him.

I spent the rest of the day doing laundry and making beds, getting ready for the next visitors.

Wednesday, July 20, 2016

Transfusion Still Working!

The transfusion from last Thursday is still having an effect on Mom; she was up at 4:30 am this morning cleaning up the dining room! How do I know this? The dining room is next to the living room, I am currently sleeping on the living room couch so the visitors can have the rooms with the beds. I asked her to go back to sleep; which she did... until 5:30 am. I decided it would do no good to keep on reminding her I was trying to sleep, it does not seem to register.

Curt and Lori took us out to dinner this evening, a belated celebration for my birthday. We went to Pagoda Floating Restaurant. Here's the card that Curt and his family gave me; when you blow on the candles the lights go out and the card plays a bunch of people singing "Happy Birthday to You!" There was a guy with a guitar providing live music; Lori tipped him and asked him to play "Happy Birthday" for me and "Aloha Oe" for Aunty Florence, Justine, Ursula, and Kai since they leave tomorrow. I requested "Kaulana Na Pua", but he did not know that one.

Here are the cards that Justine and Ursula gave me as a birthday present. They have figured out that I like cats!

Happy Belated Birthday to my friends who share the same birthdate: Susie, Leanna, and Seyda!

Monday, July 18, 2016

Shave Ice

I dropped Aunty Florence and the girls off at the Bishop Museum this morning, then took Mom for her blood draw. Every Monday morning her blood will be examined; if her red blood cell amount (hemoglobin) is less than 8 gm/dl or her platelet pack is less than 10 K/uL or if there is active bleeding, a transfusion will be scheduled for later in the week. On July 2nd, when she was in the emergency room, her red blood cell amount was 6 and her platelet pack was 13. After the transfusion on the 5th, her red blood cells went up to 9.1 and platelets to 67. The effects of the transfusion from last Thursday are still apparent, she has much more energy than she did before the transfusion. Today we had to stop her from scrubbing the laundry sink and vacuuming the house to conserve her energy for the things that only she can do!

When I picked up Aunty Florence and the girls, they wanted to go to Rainbow Drive-In for shave ice. They actually don't have shave ice at Rainbow any more, they are concentrating on their ono local food plate lunches. The shave ice is next door at Hawaii's Favorite Kitchens, just walk through the parking lot. Justine had sour apple, blue raspberry, and watermelon; Ursula had blue bubblegum with blue raspberry; and I had li hing mui pickled mango. Here's the aftermath of Ursula's shave ice; its a good thing blue is her favorite color!

Last week we saw a film crew about 1/2 block away from the house. We think they were filming a segment of the new Hawaii Five-0; one of the trucks was from CBS, which is the station that Hawaii Five-0 airs on. We think the filming took place in front of Mrs. Vea's house. We did not see any of the main actors. I guess we'll have to watch the first episode of season 7 on September 23rd to see if we can spot the scene!
Filming took place near the cars down the street

Happy Birthday to Aunty Michie!

Saturday, July 16, 2016

ER Visit #5!

Made another visit to the emergency room this morning; it's the 5th time in 5 weeks. And again it was not for me, I was accompanying someone to the ER; this time it was Kai. He said I am the common denominator, so I must be the cause... On the evening of the 7th his throat started hurting and it rapidly led to a headache and fever. The fever broke after 3 days and the cough became worse. Then the sinuses started to fill up and began to hurt. Today was the last straw so he requested a trip to a walk-in clinic. After a little bit of on-line research, I found the closest one open on Saturday was Straub Clinic. We started at their Urgent Access Clinic but when I insisted he be seen by a doctor covered by their financial assistance program they said we should go to the emergency room since they can't refuse to see people. (Kai has the no-frills Washington state health insurance. The ER folks said they will submit it to his insurance and see what happens.)

Walking up to the front of the Straub Clinic was like walking up to the front of a hotel in Waikiki. It did not look like any other hospital that I have ever been to, even one in Hawai'i. Although the ER doctor said most of the time symptoms such as Kai's are caused by viruses, he prescribed an antibiotic to knock out anything bacterial due to Mom's suppressed immune system. He commended Kai on using a mask but also recommended he use gloves to further limit spreading anything to Mom. He also prescribed a cough suppressant to help him sleep and an expectorant to break up the crud and help move it out. (Kai says the antibiotic has given him the fastest, most long-lasting relief so far.)
Looking at the front driveway where patients are dropped off at Straub Clinic, there is even valet parking!

While in Kohala, the neighbor Jessie gave Kai some salted lemons to help with his sore throat. He said they were very intense, the aftertaste was like someone electrocuting his tongue! Tomiko and I decided to try to make some, so we asked Justine and Ursula to pick us a bunch of lemons. (By now those of you who have been keeping track have realized Kai has been sick since the day after he arrived in Kona! He is hoping to have 1 or 2 days of illness-free vacation before he leaves.)
L to R: Ursula, Karen, Justime, & Tomiko

We knew we had to roll them in salt, then let them sit over night to draw out a bunch of liquid. Then they are packed in to jars to age. After we prepared these 3 trays of lemons we discovered that we started out wrong! We need to start with the lemons in a much greener state. We'll try again next year.

Happy Birthday to Dottie!

Friday, July 15, 2016

Blood Transfusion #1

Spent 7 hours at the hospital today. Took Mom in for her first outpatient transfusion. Although she has refused chemotherapy, she has agreed to occasional transfusions to keep up her energy levels and prevent bruising. Today was the first of those. She slept during most of the procedure.

Some of the things Mom missed out on in Kohala included camping out in the house - it is basically a relatively clean construction site with amenities, lunch with Uncle Kazu at Fig's Mix Plate, the Obon service and spending time with Uncle Kazu at Obon, and dinner and dessert at the house with Lem and Uncle Kazu. Here's Uncle Kazu and Aunty Daisy at Obon. David and I took Uncle Kazu back to the assisted living home just before the post-bon odori meal since the church is not accessible and he could not go up the stairs.
Aunty Daisy, Bill (Uncle Kazu's niece Laurel's husband), & Uncle Kazu

Some of the improvements I am making at the house are widening all the doorways so that they are wheelchair accessible. Once we got him in the front door, Uncle Kazu was able to wheel himself around, except for the bathroom which is still in need of work. Here's the ramp to the front door. It ended up being almost level due to the slope from the driveway to the front door. I still have to trim some of the shrubs back, add a section of rain gutter over the ramp, and add railings along the wooden part. I also have to figure out exactly where to park the car for the easiest access.

One of the reasons so many people were at the house is for Uncle Orv's hatsubon (first Obon after death). Besides the hatsubon in Kohala, there was also an interment ceremony at the National Memorial Cemetery of the Pacific, known locally as Punchbowl. Here are the Marines folding the flag. There was also a 21-gun salute and the playing of Taps. We discovered that the Marines will still do a 21-gun salute if requested but the Air Force does not due to budget cuts.

Today is the 27th anniversary of the death of my grandmother whom I am named after. In the Buddhist tradition certain nenki hoyo (yearly services) are significant and are observed by the family; this is apparently not one of the significant years. Happy Birthday to Dr. T and Brenda!

Wednesday, July 13, 2016

Mom Update #4

A lot has happened since I last posted on July 6th. Since there was no wi-fi at the house, and there were a lot of things that we had to do, I could not take time each day to find some place with wi-fi in order to post. CSC Cafe is one place, the North Kohala Library is another. The Kohala Hospital also has wi-fi but since it is so easy to take Uncle Kazu out on the town, we now spend less time at the hospital than the first year we visited him.

The results of Mom's biopsy came back late last Wednesday (July 6th). Mom has leukemia; they have given her 6 months, which she is happy about. One of her goals in life was to live longer than her mother, she made a promise to do so. At her current age, she has surpassed that by almost 8 years so she is at peace with that. The other thing she says she needs to do is get her affairs in order, so she is happy that she has 6 months. Her outlook is rather cheery and she has decided against chemotherapy in order to have a better quality of life. She will do transfusions when they tell her she needs one. Her immune system is compromised by a dearth of white blood cells, so she will wear a mask and limit her exposure to sick people. She is allowed to fly interisland but no long flights like to the continental U. S. so our trip to Washington on July 21st is out. And I am making my trip shorter since Mom has more medical appointments and she and Dad can't be left alone as much.

Look for more info tomorrow, I need to go to bed now!

Wednesday, July 6, 2016

Mom Update #3

It's Wednesday morning and I am at the CSC Cafe in Kapa'au using their wi-fi to get this posted (ask for the password when you order). It's one of our favorite places, Mom especially likes that they serve rice at breakfast! Lots of local favorites and friendly staff! Open 7 days a week from 6 am to 9 pm.

Saw another rainbow on the way to see Mom in the hospital on Tuesday morning. There are a bunch of clouds hanging around the islands for the next couple of days so there will be more rainbows.

Mom is enjoying the view from the new room. She especially likes watching the birds that come to the trees outside the window. The trees they are landing in look somewhat like madrone trees. Will have to do more research and figure out what they really are.
Mom's view from bed

Mom had the bone marrow biopsy on Tuesday. It was an interesting procedure. They use an auger similar to what we used to get cores out of trees, only a lot smaller. We have been told the actual procedure itself has little pain because of the anesthesia, its the recovery after the lidocaine wears off that is painful! (When I left, about 3 hours after the procedure, she still was not feeling the pain.)

I left on Tuesday evening for the Big Island, so posts will be intermittent since there is no wi-fi at the house. While waiting for my flight I got messages from Karen and Kai, their plane left Seattle on time but had to turn around at about 1:45 into the flight due to a maintenance warning light. We were supposed to have been coming in within minutes of each other so we could coordinate transport to Kohala, now they will be coming in on Wednesday night. The passengers at the Kona end were quite grumpy, I guess it actually affected 2 flights at the Kona end.

I was in for a surprise when I got to the house. In mid-June when I visited there were beds in each bedroom, covered by plastic groundcloths. I forgot the floors needed work, so this time all furniture was moved around and there were no beds to use. I slept on the couch, using a towel as a blanket. Here's the ramp at the front door. Yay! Uncle Kazu can come for a visit!

Happy Belated Birthday to Kathy, Gregg, and Everett!

Monday, July 4, 2016

Mom Update #2

At 7 this morning Mom called the house to ask if she could go to the bathroom. So I talked her through pushing the red button to get help...

On the drive to the hospital this morning there was a double rainbow over Honolulu; I was driving so I couldn't take a photo. Since I got here 19 days ago I have seen 4 rainbows; it's a part of living in Hawai'i, so if you don't like rainbows, don't come here! The mascot for the University of Hawai'i is the rainbow, which also shows up on the Hawai'i car license plate.

Mom is now obsessing over her financial plans. She has forgotten that they had an estate attorney put things in order for them about 20 years ago. About 2 years ago they reviewed all their plans and updated them as needed so everything is in order in spite of what she remembers.

Here's the view of the zen garden from Mom's hospital room. In yesterday's photo, her room is in the top row on the right (the partial windows), in the middle.

When I called to cancel Mom's flight to Kona tomorrow Hawaiian Airlines was great. Mom will have a credit for the amount of the ticket that has to be used within a year. They normally charge a rebooking fee but will waive the fee if I provide supporting documentation of her being in the hospital.

The echocardiogram is now scheduled for tomorrow, not sure what time; those folks were out on holiday also. The bone marrow biopsy is scheduled for around 10 am, please send good energy! (They gave her 1 unit of platelets in preparation for the biopsy, so she would clot properly after the surgery.)

Late this afternoon they took Mom off the telemetry for her vital signs so they moved her to a different ward, the pre-surgical ward, which is on a different floor. She still has a private room due to the weakened immune system. And we still have to wear masks and sanitize out hands. But the view is much better! (You can even see part of a rainbow!)
Looking mauka at Moanalua Valley

At 7:30 pm tomorrow I will be flying to Kona to meet up with family from Washington and Chicago for Obon. Mom seems to understand why she's not going. But she still asks when she will be getting out of the hospital, the only answer we have is, "In a couple of days."(Since I will not be in Honolulu for a week I will not have any detailed updates on Mom's condition. Also, my access to wi-fi will be sporadic so posts will be delayed.)

Happy Birthday to Becky!

Sunday, July 3, 2016

Mom Update #1

Mom is doing better today. Her appetite is back and she is surprising the doctor and nurses with how much she is eating. Her red blood cell count is back to normal due to the transfusion so she is no longer out of breath. In fact, this evening they began to decrease the amount of oxygen she is receiving.

The main condition that Mom has that is causing problems is called pancytopenia, where the counts for red blood cells (rbc), white blood cells (wbc), and platelets are all lower than normal. In Mom’s case her rbc was at 6.0 (normal range 11 or higher), wbc 1.1 (range 5.0-10.0), and platelets 12 (range 150-300). Secondary conditions are congestive heart failure and an insufficient tricuspid valve (heart murmur).

No tests were done today to help figure out the cause of the pancytopenia; the holiday schedule is delaying both of the tests that they would like to do. It looks like the echocardiogram will be done tomorrow (Monday) and the bone marrow biopsy will be on Tuesday, which means she won’t be going to the Big Island. But that sounds like a safer plan for Mom. Her wbc count is so low they are concerned about her getting an infection and being unable to fight it off. All visitors must wear a mask and sanitize their hands before coming in to her room, she is not allowed to have flowers or plants in her room, and she can’t have any raw food. The doctor and nurses must also wear a mask and use gloves when examining her. They even wipe down their stethoscope with alcohol wipes before examining her. They also removed the catheter since that is a potential source of infection; since her rbc count is back to normal she is no longer out of breath just getting out of be to go to the bathroom, so that’s okay.

The stress of these conditions on her body is making her memory worse. She is having great difficulty remembering what she said a few minutes earlier. We have taken to writing several things on the white board in her room. Like, “Push the red button to get help to go to the bathroom or get out of bed.” She’s got so many wires attached to her its a major production just to get out of bed! Less than an hour after Dad visited her, she could not remember that he had been there.

Here's a zen garden in the middle of the hospital.

Happy Birthday to Marvetta and Michael!

CAUTION: ERs May Become Habit Forming!

Does this look familiar? If you have been a faithful reader of this blog you will have seen a similar photo on June 12th, June 19th, and June 22nd; 4 of them in less than a month!  
This morning Mom got so winded walking from their bedroom to the kitchen, she had to lie down on the couch to catch her breath. She asked me what was wrong, she also was nauseous and the edema in her right leg was all the way up to her knee and the left leg was also swollen. She also had difficulties when they were in Las Vegas, including one incident that had Curt so concerned that he almost called 911. When I went to call Kaiser to see if I could get an appointment for her today I discovered the Honolulu clinic no longer had Saturday hours so I had to call the After Hours Care line. After a bunch of questions they advised me to take her to the Moanalua ER. In the past, they told me to either call the next business day and have her make an appointment with her PCP or to make an appointment through the After Hours Care line and take her in that way; never the ER, so it sounded pretty serious to me. It took Mom about 45 minutes just to change her clothes because she was having such a difficult time breathing.

The triage nurse at the Kaiser Moanalua ER asked a bunch more questions and checked her in to a room. He was back about 15 minutes later to do a “proactive” blood draw. (His term, no doctor had reviewed his intake and conclusions.) The ER doctor came in and also sent her for a chest x-ray and echocardiogram because they suspected congestive heart failure. When the results came back from these they determined her heart was somewhat enlarged due to having to pump more because she had extremely low red blood cell (rbc) counts as well as low white blood cell (wbc) and platelet counts. They sent another technician in later to do another blood draw for typing in preparation for a transfusion. At this point they had no definitive cause, they just knew she was staying overnight. The nurses, technicians, and doctors are down-to-earth, friendly people. I even like the way the improvised the fix for the mouse, I did a similar thing at work with a chopstick!

They have gave her 2 units of blood plus lactated ringers solution because she was also dehydrated; the transfusion is about 3 hours per unit. The also gave her anti-nausea meds and a diuretic to get the fluids out of her tissues. They also did an ultrasound on her leg but determined that there was no clot. Tomorrow they are doing a second echocardiogram and a bone marrow biopsy. There will also be a consultation with a hematologist and an oncologist.

In between all this the nausea subsided and she got hungry. The nurse gave us a menu and told us to choose what she wanted and call it in from the room phone. It was basically room service with a dietician taking your order at the other end and telling you if you are allowed to have whatever you ordered or if it needs to be revised. I can even call her breakfast order in from outside the hospital!
Notice the local dishes that are available

She told the internal medicine doctor that will now be treating her that she wants to go to the Big Island on Tuesday. He told her he would do his best to have all the tests done by then, though he may not have a conclusion or treatment plan at that time. He told her she would feel better than when she came in but not good enough to dance for all of the bon odori. He also advised her to take advantage of someone pushing her around in a wheelchair, when she needed to just walk somewhere, so she could save her strength for activities that were more fun than walking. (Tomorrow I will check in to wheelchair rentals from the Kohala Hospital.)

He also said this condition did not develop over the past few days, it has been developing at least since January of this year. At that time her platelet count was low and her rbc count was at the low end of normal. He said the low oxygen (caused by low rbc count) would eventually start damaging organs if not treated, so it was a good thing she came in to find out what was wrong, rather than thinking all of her symptoms were just because she was getting old.

This explains a lot of the things that have been happening over the last 6 months or so and especially over the last couple of weeks. In January I had noticed that she has a lot of bruises on her arms and in Vegas she also had a bruise on her shin that ruptured and bled in to her sock. The low platelet count means she does not clot normally so bumps that rupture small blood vessels would leak for a longer period causing a large bruise. Her complaints of being tired or not being able to breathe or legs feeling “heavy” are from lack of oxygen in her tissues due to the lack of rbc’s.

Of course, during all of this my phone had to get temperamental. (In fact, it only got me to the freeway on ramp. So it was a good thing I had been to the Moanalua clinic 2 previous times in the past 3 years and knew the general vicinity.) Even though my phone was fully charged I was having to run it in the ultra power saving mode in order to get it to work at all, which eliminates a lot of functions. The ones I have available are texting and calling, but I limit the calls I will take and use Mom’s  phone to make calls.

I will go back tomorrow morning to consult with the doctor. Curt and Lori will also be back there some time tomorrow. Dad said its a good thing I came back when I did! For Mom, the jury is still out; sometimes she likes that I am back, sometimes she doesn't.

Friday, July 1, 2016

Mom Under the Weather

Filled up the RAV4 before I went to the airport. Gas here is now only a little higher than it is in the continental US. When I was first learning to drive it was about 4 times higher here. Today it was $2.699/gallon.

Took care of paying Mom and Dad's home insurance as soon as I got them back from the airport. Dad was very appreciative of my taking care of things. Mom can't remember from one moment to the next why something like having their home insurance properly paid is important.

Turns out Mom does not remember ordering the Supple and TurboFlex at all. And she says she does not want to be taking any more pills. I will call to cancel tomorrow, if I can; otherwise I will do it on Tuesday. In the meanwhile, she says she will take it since she apparently ordered it; we shall see.

Mom apparently has not been feeling well the last couple of days. Her stomach has been upset. I guess she even threw up a little on the plane today. I got her some ginger ale this evening to help settle her stomach. She ate a little dinner, about half of what she usually does. But she did well on dessert. They both really liked the brownies so I heated them up in the microwave and served them with a little ice cream. Dad now wants more brownies! (Times Supermarket had a sale, so I picked up 2 more boxes of mix when I got the ginger ale.)

Here's Shiro getting ready for the evening hunt. He still calls for his brother several times a day.

The folks at the Hawai'i Humane Society are getting to recognize me and have almost memorized Momo's lost cat report number. (They make an entry every time I stop in to check for him.) They have been fairly helpful so far. The latest thing I have discovered is that their website of lost animals is updated daily, however, not all animals have photos posted. They told me how to find the ID number for each post in the URL so I can keep track of who is new. During the period that I am gone, they said if I see a cat that looks like Momo, to call and ask them to re-check him for the microchip (his has migrated towards his right elbow). And if they find him while I am gone they will make a note and hold him until I get back (but there will be a small boarding fee). I saw a cat on the website this morning that I thought might be Momo, but he was not at the shelter; perhaps he was reunited with his family before I got there.

Happy Birthday to Sandy!