You Gotta Love MDD

Also known as Major Depressive Disorder.

Every single time Rich's MDD has come along [it runs in cycles, meds work for a while and then...] ... well then it creeps in slowly.

First red flag is him being extremely critical of every THING I do. I didn't feed the mules properly. I should be standing and watching the 300 gallon tank fill. The coffee tastes bad [I make coffee to his specifics each morning separately than my own coffee].

The sun is shining. The sun is not shining. 

~~~~~~~~

I went into the woods to get that very first black morel mushroom. I thought it would make him smile. 

He went off on some strange offshoot and gave me a lecture regarding mushroom hunting. He then went on to tell me about some weeds I had to go work on in the forest. I mentioned that the jewel weed was there in 2010. An argument ensued. 

The grand kids in Jewel Weed July 4th 2010. Yeah, that is the only reason I know exactly what year it was.

[He hasn't been in our woods since 2016.] 

Bam. It hit me. His time frame was different than mine. 

So.

I agreed with him. Yes, I needed to take care of the Jewel Weed. I didn't even talk about the Dexter Cattle taking care of that for us. Best to let some things just drop.

No sense in trying to correct a memory. He has his own time frame that gets mixed up a lot. I guess I am going to have a long discussion with the Caregivers Social workers next week.

Another thing he has issues with once in a while, is that he thinks he is a randy 19 year old. Full of vim and vigor. A sexual god if you catch my drift. This is awkward but I'm going to address it here or my head will explode.

He thinks I am mean when I rebuff his strange advances. He forgets that once he tries intimacy it all falls apart. He can't breath and he can't do what he wants so he gets very angry or very depressed. I am then stuck in the house with clouds of charged particles in the air.
It is like walking on nuclear egg shells.

He cannot walk to the shed without a rest. He struggles when just getting dressed or undressed. But in his head he is a sexual god and it is my fault when he isn't. There really is no win-win to this at all. His is a fantasy in some ways which lives in his head. With mild dementia it is all true. He is the god of sex. 

Well...until he gasps and asks me to set up his oxygen that is....

So instead of worrying about life with the god, I keep my head down and do the mundane things that I am supposed to do. I go for walks. Which became an issue in itself. 

He decided that since I had the vaccine I should sleep or sit on the couch. I shouldn't go...go ... go. 

His depression. It is insidious and creeps up getting worse and worse until the black hole swallows him. His latest med change was a last ditch effort and it worked for a pretty long time. Just over a year. 

I'm his caregiver. There are days when I want to close the door and walk away and keep walking never looking back. 
But I am not that kind of person.

He struggles with his mind. He knows that he used to be young strong and invincible and somedays he still thinks he is. Then he is angry with the betrayal of his health and mind.

I am the only other living soul here on our farm. So I get to be the Fall Guy. 

I miss my friend. 

I miss my sense of adventure and doing my own thing whatever that was.
I've bowed over and over to the goddess of MDD.

It makes me exhausted.

Offering some hope

We met with Rich's PCP...Primary Care Provider this week.

She is one very straight forward person and she also tells you like it is.

"How are you today Mr. Ewing?"

Rich shrugs. "I'm dying bit by bit."

She answers, "We all are, but I understand how you are feeling. Your meeting with Neuro-psychology flagged you for severe depression. We need to turn that around as quickly as possible."

Rich stares at the floor and then something far away. "Nothing can make me feel better, I just want to feel better once, you know?"

She nods. "Of course you do! I've put in a call to your psychiatrist and he needs to review you AND see you ASAP."

I interject. "I wonder if his meds don't work any longer. Rich has a history of his medications for depression working well for about 6 to 8 years...and then..."

She nods and types swiftly, "You are absolutely right. We may end up with a different regime of meds. And speaking of that we are going to stop the Tamulosin right away. I think you have had nothing but poor reactions to it..."

I pipe up. "I know Rich doesn't want this, but can we look at oxygen therapy? Lately he can't function very long without going back to lay down with his CPAP and 02. He feels extremely fatigued and 'out of it'."

She nods sand turns to Rich. "We will test you, and your heart, your lungs are not elastic so you may need oxygen to keep from damaging your heart, lungs, and brain further. Are you open to that?"

Rich makes a face.

Doctor pats him on the back and says, "Struggling to think, to walk, to breath, is no fun. This will help."

I point out that since he spends up to all but 4 to 5 hours a day with his CPAP and 02, that he is already ON oxygen. She agrees and I see Rich make that connection.

He asks about the aneurysm. She looks at it and says, "If they want to do it, go for it. IF you go in alive you come out just fine." She is not being cavalier, just straight forward.

She types some more.
"I'm ordering a stress test for your heart. I'm putting in for an immediate re-eval of your psych meds."

Then she turns to him. "You know, you are dying, we all are, but I think we can make some adjustments so you don't feel so depressed, so tired, and so frustrated.
I'm going to put you on Aricept for your dementia. I see you will be visiting speech therapy, OT, and cognitive therapy."

She raises her hand and draws a line. "I want to hold you here for along time. Mr. Ewing, you will live and you will feel better. You have a good partner and wife, she is looking out for you."

We leave and I think we both feel a bit of hope.

Is it real hope? I believe so. Because not believing it is not going to help us.
Hope always helps.

I am Nowhere.

So on the last check up with ENT a week ago there is still no re occurrence of cancer. Everything looks 'good'. 

We both sighed at that thinking soon the endless appointments and follow ups regarding the dreaded 'C' word would slow down to a six month break.

However Neuro-Surgery called and scheduled a CT scan to check out Rich's brain and to see if there were any changes to his brain aneurysm. After we got home a Neurosurgeon called to let us know that no significant changes had occurred but we were still scheduled to see them for his one year follow up.

The results from the tests with Neuro-psychology were in. Cognitive Disorder...Vascular Dementia. The full results will be mailed to us in two copies. One for Rich and one for me.

I think they will write up and include their recommendations. There was almost too much information given at our meeting of nearly 90 minutes.
My take away was the following.
Are POA's in order? Yes.
Driving? That will be addressed with OT/PT.
Could I now prepare his meds? Yes.
They are ready to invoke POA for Medical as they don't feel Rich can make decisions for himself.

I did explain that all of our decisions were made together and had been since he'd had cancer. 
The best thing I liked about these doctors is that they looked Rich right in the eye and explained things to him. They also confirmed that I understood what was going on.
I'd already had an inkling of the possibilities before the appointment.

The signs were all there. The confusion, the far away looks, the getting lost in 'No Where Land' as Rich had told me over and over again. The lack of ability to make an easy decision like to call to have his truck fixed, or to arrange to have some cattle shipped is now beyond his reach and thought process.

As I explained to our Farmer Friend, I wanted to let Rich feel like he was making the call, that he was still in charge. But I realize now that he may not be capable any longer. He has become mostly apathetic to what is going on around him.

It seems that decision making is too difficult for him. I've resisted that thought, I've resisted that conclusion and I had even decided that Rich was just too lazy or unconcerned to make these important decisions. I'd leave a phone number in front of him to call for his truck. He'd push it away and not look at it. I nagged, cajoled, and begged for him to call.
I got an irritated look in return and then nothing.

The shock for me is that it was there in front of me and I didn't want to believe it. 

Yesterday morning I felt lost. I felt panicked with the sudden realization that indeed my world had flipped again and so had Rich's. He was slowly drifting away into a place where I couldn't find him.
He can sit and have coffee with me in the morning. But I look at his face and find him not there.
His eyes are blank.

I ask him what is on his mind. And he blinks, then looks at me with a question on his lips and says, "I am nowhere."


My husband is leaving me. No dramas, no slammed doors - well, OK, a few slammed doors - and no suitcase in the hall, but there is another woman involved. Her name is Dementia. ~~ Laurie Graham.