Apologies, as I thought I updated this last month and I guess I didn't. Mom has been doing much much better since her sister came out from Georgia in early June. The fear I was having over her lack of control over her medication was that she would end up going into a home - which I know she doesn't want to do. I think having her sister here encouraged her to do better and try harder. She is taking her meds on time and paying attention to the dates (so proud of her!!) and she even took them with her when she was out (yes, out of the house...for up to 12 hours at a time!!) with her sister or brother. She was quite active for the ten days that my aunt was here and remained active for about a week after she left. I think it's catching up to her now. She twisted her ankle and bruised it somehow at the end of May and it refuses to heal. She props her knees frequently, but says that propping up her ankle makes her back hurt, so she dangles it downward most of the time, preventing it from healing. She has been nauseous for about a week and is starting to cancel appointments. She has canceled a dentist appointment twice and hasn't seen her mother in over a week and doesn't feel well enough to go today.
She tried to cancel the appointment with her liver specialist yesterday, but it takes months to make an appointment with him, so she went. Her bloodwork came back very good this time. Her AST and ALT levels are in range. Read: they were NORMAL for the first time since 2009. Her Alk phos is down to 158, and the high is 150. Her MELD score (click for more info) is only 8, down from 10, which means her liver is just barely "sick". Her belly is distended - she looks about 4-5 months pregnant. The digital ultrasound of her abdomen indicated there's quite a bit of air and ascites in her belly. The ascites is purely caused by her diet. The doctor's resident took a look at the box label we brought for her shrimp wonton soup (since I couldn't make heads or tails of it) and it turns out that one bowl of soup is her daily intake of sodium. If she eats more than that one bowl of soup in that day, she's already over her limit. He also advised that pickles are very high in salt and that her belly would not be distended if she didn't eat so many salty foods. She argued with him and told him she barely eats two servings and that her belly was caused by chili dogs she ate a month ago with my aunt. The specialist told her that there is no debate and no argument; it's simply reality that her diet is salty so she has ascites. Period. She still refuses to believe this, so she asked for proof and a copy of the ultrasound that shows that she has ascites in her belly. She is addicted to pickles like some people are addicted to crack. She uses phrases like "I've been on the pickles for a long time and I'm not getting off of them!" She eats pickles at night when she is stressed and can't sleep. This is clearly her decision; some people could choose to have a bit of a belly and painful distention if they want salty food that much. The problem lies in the use of water pills to compensate for it. She is already on high doses of two common water pills and if her diet is salty, they get increased to keep up with her. Water pills don't just rid her body of salt - they're called "water pills" for a reason. They dehydrate her. Then she gets into a cycle of drinking a lot of water constantly (Mom hates water and can't eat or drink much in one sitting as her stomach is quite small) or she will end up needing IV fluids again. I'm trying to get her into therapy for the pickle addiction, but I doubt that'll happen any time soon. She doesn't believe in therapy and doesn't believe her addiction is a problem.
Generally her attitude is much improved as of late. Since her sister came (though Mom swears it has nothing to do with that), she has been pleasant and even cracks a joke once in a while. She still has her panic attacks and freak outs, but they are slightly less frequent and she is less angry during the time in between fits. She does dream rather vibrantly and believes things happened that didn't. We tend to let her believe it to be true unless it's a real problem, but it's better not to argue and upset her if we can get away with it. It's nice to get along with her more often and enjoy her company. Her next specialist appointment is in another two months (or it should be, but it never happens on time). I shall update as needed.
