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Dear Friends: After one week in the rehab program Barbara seemed to be recovering; her medications had been reduced substantially and she seemed more awake, more alert, and more lucid since she went to the hospital on 19 August. But that was last week. We had a conference with the staff of the rehab center; it included the very immediate family ( Barb and I, Aaron and Leah), and the supervisor, social worker, physical, occupational, and speech therapists. The consensus was uniformly pessimistic. Last week, our neuro increased the medications from 350 mg 450 mg dopamine to correct end of dose pains which normally indicates insufficient dopamine. This apparently seemed to arrest or even reverse some of the progress we thought we had achieved. The hallucinations and psychosis that had been waning, were returning. This interfered with the therapies to move about safely (walking with a walker) , to take care of herself (bathing, grooming, etc.) , and to be able to feed herself with or without assistance. Near the end of the conference, the social worker handed me a copy of a booklet discussing making hard decisions for end stage of life and contacting hospice care. I noted from the booklet that Barbara had all but one of the half dozen or so symptoms indicating end stage of Parkinson; she did recognize those dear to her. Our neuro was optimistic early on during her stay in the hospital, and then again when I took Barb to her office last week. I left a message for her to get in touch with us in the AM. Leah provided me with a cell phone which I will probably return after this crisis. I hope to be more upbeat after tomorrow's attempt to juggle or titrate the medications to reach a more positive balance. We ain't givin'up !!! with love to all, Michel Margosis 'Carpe Diem'