Guess Who We Bumped In To Today

Mom had to go in to the lab at the Kaiser Honolulu facility. Nurse Rachel was unable to get any blood out of her yesterday since she was a little dehydrated and they have had a hard time getting blood out of her recently. The phlebotomist today was Yvonne, although Mom is a "difficult stick", she was able to get enough blood out of Mom for the test to be done. On the way out we saw Mrs. Vea, so we stopped for a few minutes to say, "Hi!". She was at the Kaiser pharmacy to pick up a prescription.

Mrs. Vea & Mom at the Kaiser pharmacy.

A few of Mom's mahjong buddies came over later in the morning. It was basically just before lunch so Jocelyn, Sandy, and Mitsie brought over some kombu soup, maki sushi, and inari sushi.

L: kombu soup; R: center maki sushi, outer edges inari sushi.

While at the blood draw this morning, both the phlebotomist and I noticed that when she withdrew the cannula the blood did not clot, it just seeped under Mom's skin, quickly creating a very large bruise. When Dr. Thalody released Mom on Tuesday, she had mentioned that this was one of her concerns, that Mom would not be able to retain the platelets that they had just given her. After finding out later in the afternoon that Hospice Hawai'i would do physical therapy for Mom to keep her safe as she moved from the bed to the bathroom and back again, I talked to Curtis, and we agreed that we should start the hospice process as soon as possible. I called Lucy back and she was at the house about 3 pm.

It was a very interesting meeting with Lucy. Besides signing the papers to get the process started, Lucy also talked about revising Mom's medication schedule, diet suggestions, sleep schedules, and a bunch of other things. Regarding Mom's medications, she is reducing Mom's lisinopril to 10 mg/day for 7 days, then stopping it completely. She said at Mom's age they want to keep her blood pressure up a little higher. She also said to stop taking her blood pressure with an automated cuff because it can cause fragile blood vessels in elders to burst, and with Mom's lack of platelets that is not good. So we're leaving it up to the hospice nurse to do during her weekly visit.

For Mom's neutropenic diet, Lucy said certain raw fruits were OK like papayas and bananas; she can also have melons and berries, and applesauce is really good. But no pineapple and only a little citrus. For vegetables she can only have cooked ones. Eggs and tofu are highly recommended, as well as soups and ice cream. Ice cream? She said in hospice they look at "pleasure feeding." Since the disease (or sometimes the treatment) can alter the taste buds, what is it that still registers with the brain as a good taste, thus making the person want to eat it? She said ice cream is a favorite of many clients because of the sweet taste. But soups also work well, too. Other good things to try are dairy including cheese and yogurt, fish, and chicken. But not beef or pork since they are heavier and not as easily tolerated. Tonight Mom had kombu soup, rice, and an apple turnover; she ate it all, it was the most she has eaten since she returned from the hospital.

One of the other things Lucy brought was the Hospice Hawai'i welcome bag. It contains disposable underwear, exam gloves, dental swabs, a calendar, and a fridge magnet with their emergency number. Lucy said Mom should be using the dental swabs instead of a toothbrush since she is low on platelets. She said toothbrushes can cut her gums and cause bleeding, which Mom should avoid. I tried to have her use it tonight, but I caught her using the toothbrush when I wasn't looking. Auwe!

Here are the dental swabs.

One of the good things about hospice is that Mom won't have to go to the emergency room again. If there is a problem, I call the Hospice Hawai'i number and they send a nurse over and possibly a doctor, depending on what it is. She also won't have to go to the hospital for any procedures or palliative care, the staff will come to her. This morning, even with the oxygen, she had to rest after she walked from the bedroom to the family room; she was out of breath and tired. Having people come to her will be a lot easier on her.

Happy Birthday to Melody, Deanna, & Clarissa! Happy Blueberry Popover Day, Mario Day, Pack Your Lunch Day, Women and Girls HIV/AIDS Awareness Day!