The Good, the Bad and the Ugly

WARNING: This post touches on bowel incontinence. If that makes you uncomfortable, you may want to skip it. 

Yesterday was J’s birthday and it was nearly perfect. J had said she wanted to see the San Diego Zoo, and that is exactly what we did.  The highlight was a little monkey who was intent on retrieving some food on the other side of a chain link fence. Talk about persistence!  J delighted in watching the monkey stick its arm through the fence and reach under a tarp for hidden morsels. Of course we also saw the pandas and gorillas and tigers and many gorgeous birds. 

Later that afternoon, we headed to La Jolla, where we watched the sun set and then had an over-the-top four-course dinner. Both our children, J’s brother and sister-in-law and many friends had called that day. That prompted reminiscences.  It was a warm and loving evening, despite the need for heaters and blankets while we watched the first star come out. 

The prior day was not so easy. J has been having a diarrhea problem for the past three or four months. Diarrhea is a known side effect of Aricept, one of the few medications on the market for Alzheimer’s disease. I had discussed the issue with J’s neurologist/psychiatrist and her internist. We decided to stop Aricept and start Namenda, another Alzheimer’s medication without this particular side effect. J seemed to be tolerating the Namenda well and I was under the impression the diarrhea had stopped. 

Until we were walking on Sunday in Balboa Park.  J asked if I had a tissue. I didn’t.  I noticed her fingers were brown, but we were walking in a park, so I thought (or perhaps naively hoped) it was dirt. I asked J what was on her fingers. “It’s shit.”  Fortunately, we were close to a bathroom. I went in the stall with J and realized for the first time that she is no longer able to clean herself thoroughly. That led to a supervised bath and shower at the house where we were staying and a trip to the market for wet wipes.  I now go into the bathroom with J and make sure she is clean. J does not always welcome me there. 

I also have had to give much more direction to her about getting dressed and other common tasks, like how to make a bed. 

These realizations are going to have to lead to changes at home as well. I need to keep closer watch, and need more help. I’m still working on that. 

The San Diego trip, however, was more than worth it. When we got home this evening, J said, “I couldn’t …,” trailing off after those few words.   That translation was easy. “I couldn’t have done it without you.”  That will get me through many a tough day. 

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