Salivation Problem

This afternoon Kate and I went to a movie, Columbus, at The Flick. This is the second time at there this week. Two days ago is when I made the entry about her being angry with me over not recognizing her salivation issue that lasted for the entire movie. Today I went with a minor concern over whether or not she would like the film, not thinking about salivation. After picking up our tickets and ordering soft drinks, we started to enter the theater when Kate asked for a napkin. I went back to the lobby and picked up several of them knowing that one would never be enough.

We went through the introductory video with recognition of the donors and some advertising as well as the previews. She used one napkin and asked for another about the time the film started. That left me with only one. At that point I knew she would not have enough to get through the movie, but I didn’t worry because she doesn’t usually have napkins throughout a movie. Today I was more sensitive to her salivation than two days ago. She was obviously struggling. She burped out loud a number of times and had used up her last napkin. I was getting concerned about burping and the possibility that it was loud enough to be annoying to others. I asked her if she thought we should leave. She nodded. We got up and left. As we walked to the car, I asked if she could explain what she was feeling. I asked if it seemed just like ordinary saliva. She said it was. I then asked if it was coming up from the throat or within her mouth. With her hands, she indicated that it was coming up from the throat. I then asked if she were able to swallow the saliva. She tried and was successful. I told her to keep doing that and see if that helped. She did. I didn’t say anything more.

She continued to have the problem all the way home but did not burp again. She did stop swallowing the saliva and kept a napkin to her mouth until we reached home. When we got home, she wanted to know if she could work outside. I told her that would be fine. As she is accustomed to doing now, she asked if she could use the clippers. Then she asked me where she could go. I told her she could choose to start any place she would like. She said the thought she would start out front and looked to see if that were all right. I told her that would be fine. We were now back to normal.

I should comment on what I mean by normal. It still appears that she doesn’t swallow her saliva most of the time. As I noted a week or two ago, she does periodically stop. I suspect that when for some unknown reason she thinks about the salivation, she stops swallowing. In the case of the movie, she is very inactive and, perhaps, that heightens her awareness of salivation. Then she has a reaction like many I have witnessed before. The interesting thing is that she uses paper products to wipe away the saliva all the time; however, she doesn’t always have the negative emotional response that she had on Wednesday and today. I don’t yet have an explanation for that.

Déjà vu

It has been a good while since I mentioned anything about Kate’s Deja vu experiences. I am only doing so now to indicate that they still continue. For example, as we sat at a stop light coming to Panera this morning, a man walked across the street in front of us. Kate said, “There he goes again.” She also continues to see people she “remembers” at the restaurants we frequent. I typically say, “So you’ve seen him/her/them before.”

Speaking of things that continue, Kate is still not swallowing her saliva, and I have not heard from her doctor’s office since I left an email message for the doctor. I have called the office and left a message for the doctor’s nurse. She called me about 3-4 weeks ago. I explained my attempts to contact the doctor. Two weeks ago, I sent a letter to the doctor who started her practice. In that letter I told him about the events that had transpired since the end of June. I have not heard from him or Kate’s doctor. Something is really wrong with respect to communication. I am only glad that it does not appear to be a significant problem. It was a year ago this fall that I first mentioned the problem to Kate’s original doctor who is no longer in the practice.

Salivation Crisis

I have mentioned on several occasions that Kate continues to have problems with salivation. The doctors have recommended several things over the past 6-8 months. Initially, we thought it was an acid reflux problem. That led to increasing her omeprazole. That didn’t work. We tried an antihistamine think it might relate to allergies. That didn’t work. Then Dr. Reasoner tried atropine. No luck. A month ago Dr. Reynolds gave her a prescription for glycopyrrolate. That doesn’t seem to have worked.

Since I could see no visible signs of acid reflux, I have been thinking she has just “forgotten” how to swallow her saliva. Increasingly, I have felt it is more than that.

Yesterday and today at lunch she has had difficulty eating. On both occasions, I thought it was acid reflux even though I couldn’t see some of the ordinary external signs that go along with that.

I gave her Gascon tablets to see if that would help. It didn’t. It is almost impossible to get her to tell me how it feels or give some some sign of a symptom so that I will be able to have some direction as to what to do or to tell the doctor. I finally got her to say one thing. She said her throat felt tight.

After she had taken the tablets, I asked if that was helping the problem. She asked, “What problem?” I don’t know whether she was temporarily forgetting her problem or that she didn’t think of it as a problem. When I tried to explain, she indicated that she still had trouble swallowing.

We remained at the table a long time. Finally, we left, but the problem was not over. It has continued all afternoon. I am at a loss as to what to do now. Tomorrow I will contact the doctor to let him know the situation and to say that she feels her throat is tight; so it is difficult for her to swallow. Maybe that will lead him to some other issue that can be addressed.

I am puzzled. I hope the doc has an answer, but I feel he won’t. This may be something that requires further testing.

I am also wondering if it could be a symptom of something more serious. I recall that on our trip to Machu Picchu and the Galapagos, someone traveling with us mentioned the serious of acid reflux and that left untreated, it could cause cancer of the throat. I am now wondering about that. That seems strange, however, as we have had the reflux under control for quite some time.

This is our first medical issue (if that is what it is) since her diagnosis. I hope it is nothing serious. I have just written a message to Kate’s doctor that he will get in the morning when he checks his email. I plan to call him as well.

Salivation

I don’t think I have written much about Kate’s problem with salivation, but it has gone on for at least a couple of months, possibly more. The symptom that most people are likely to notice is that she goes through paper products right and left. When we are in a restaurant, she uses the paper napkins give to us. That includes both the napkin to use with the meal as well as the small cocktail napkin that often serves as a coaster for our drinks. She goes through hers rather quickly. Then she gets my cocktail napkin(s). At home she uses Kleenex and toilet paper and paper towels.

At first, I interpreted this as an acid reflux issue. I even sent a message to her doctor describing it as a reflux issue. Dr. Reasoner told me to double her reflux medication. If that didn’t work, she said to try an antihistamine which I did. She also suggested a diet change, but I’ve not tried that. I don’t think Kate is ready for that.

After months of this, I have decided that the problem is that Kate has forgotten that we swallow our saliva. She doesn’t like to do that. I decided this after watching her carefully all this time. I see no physical signs of reflux
A week ago I mentioned to Kate that she used to swallow her saliva. I also asked if this bothered her. She acknowledged that it does. She even agreed to try to swallow rather than spit. It seemed like she was having some success. It wasn’t that she swallowed all the time but that she at least did it sometimes. Now she seems to have gone back to her old ways. The big exception is when she focuses on something. Right now she is working a jigsaw puzzle on her iPad. She is not spitting out any saliva. I’ve observed her outside pulling leaves and pruning. It appears that she does not spit. It also seems like the most typical time for this is when we go out to eat. Of course, that is the time that I have the longest period to observe her.

At the moment, I don’t know what else to do. I think I will continue to mention that she can try to swallow and see what happens. Otherwise, it may simply run its course.

Acid Reflux?

I don’t know how I could have failed to say something about what may be a recurrence of acid reflux. This is an old problem for which we found a resolution two or three years ago. Since that time she has taken a prescription for Prilosec that had solved the problem. About six months ago, she experienced a couple of instances of the problem. I thought the problem had gone away on its own. Kate said she was eating more slowly which she believed helped to prevent a recurrence

I can’t recall exactly when, but she started using extra paper napkins at restaurants. This typically occurs before she has even eaten anything. As I reflect, it is something that occurs at various time during the day. She goes through lots of toilet paper which I now believe may be associated with this problem. Let me describe the problem as well as I can

Unlike her previous experience with acid reflux, what she is experiencing now does not involve exactly the same symptoms. When she has had the more serious experiences, she has to stop eating. She usually lowers her head slightly and appears to be trying to calm herself. With the current problem, she can continue to eat. As I have already mentioned, she will be having the experience before food arrives at our table

To me it appears that she is simply spitting up saliva. I do not see any visible signs that she is experiencing acid creeping up her esophagus. It is more like the normal salivation collects in her mouth, and she spits it out. I think one reason I haven’t mentioned it before was that it never seemed like something serious. In the past month or so, the problem has become more serious and seems to bother her. In fact, last night she had some difficulty getting to sleep because of it. I suspect it was more than an hour before she got to sleep after going to bed. She got up at one point. I heard her burping in the bathroom next to our bedroom. That led me to give her some Gaviscon. Before she was taking Prilosec, I gave her Gaviscon when she had a problem. It always seemed to work. I have tried it several times recently without the same success. I am not certain that it helps at all. I do know that she finally settled down and slept well during the night

About three weeks ago, I sent a message online to Dr. Reasoner, Kate’s doctor. She suggested that we try several things. She said we could take a second Prilosec in the evening. She also said if that didn’t work, we could try her taking an antihistamine. Finally, we recommended staying away from acidic foods and beverages. I tried doubling Prilosec and could not tell any difference at all. I dropped that. I then tried adding a Claritin with her morning medications. I have not been able to detect a change though I plan to continue to give it a fair chance of success. My reason is that I think her symptoms seem more like a post-nasal drip which sounds like an allergic reaction
One other symptom has made me think of the situation as more serious than I originally did. Within the past 4-6 weeks, I have noticed that she sometimes starts burping when she takes her pills. That made me think there might actually be a gastro-intestinal source of the problem. On the whole, however, I find it very confusing. What I know is that it has become a chronic condition that annoys her. It also concerns me that it might possibly be a symptom of something more serious. Unfortunately, Kate is unable to provide any kind of description. I am hoping that we might have a conversation with her doctor. I think her next appointment is in January or February

Kate does drink a lot of tea and Dr. Pepper. That would be the next step to try. That will be a hard one as these are long-standing habits.

Sunday Afternoon

This is a continuation of the post I started before lunch.

As I was saying, Kate was ready to go and then went back to the bedroom and got into bed. I went in to see if she wanted to rest a little more. She indicated that she did. Once again, she wasn’t in bed too long. We went to lunch. The line at the regular register was so long that we went to the “Grab and Go” line where Kate got a slice of pepperoni pizza. I got the strawberry and walnut salad.

After paying I looked around and Kate had disappeared. I looked in several places and finally found her sitting at a table with the same couple we sat with last night. Kate was not as talkative today. When we finished eating, Kate asked me where the nearest restroom was. I showed her. It turned out that she is having a problem with diarrhea. When she came out, she was quite hot. We came back to the room where she took off her clothes and got into bed. I gave her an anti-diarrheal medication. That was a little over an hour ago. She is still in bed. She seems to be quite tired, but she and I both enjoyed the morning worship service. I am now hoping he will want to go to the evening sacred song service. I don’t want to leave her alone. The good news is that we are close enough that I could sit on our porch where I am listening to a concert performed by one of the military bands. Of course, I would rather be in the audience, but this would be the next best thing.

I am beginning to think about the possibility of coming back here for the last week in August. I think Kate would be up to it. I am certain that next year is out.

Recovering from our Colds

Today seemed like a day of progress in recovery from our colds, at least for Kate . It is peculiar, but we both seem to have trouble early in the day but are better later in the afternoon and evening. It has been hard for me to determine how much of her listlessness is a result of her illness and how much might be a result of her Alzheimer’s. I suppose I will see in a few days. I think it has been a combination.

She is still asserting her independence but also showing her need for and acceptance of my help. Today, for example, I noticed that she had not taken her medicine. Instead of telling her that she had forgotten (which I usually do) I simply took the pills I knew she really needed and gave them to her. She never asked any questions, just took them. I might have thought she would ask where the others were, but she didn’t. She easily accepted my help. On the other hand, tonight when I gave her her medicine (she had forgotten to take it again), I told her to be careful because there were a lot of them. She said something to me that clearly indicated that she didn’t need me to tell her that. The reason I had done so was that earlier when I had given her the pills she had missed this morning, she dropped one of them in her bed and couldn’t find it.

I am sensing there is greater importance in my trying not to push her too much. After getting out of a movie at 2:30 today, I told her we needed to get to our haircuts. She expressed displeasure in that prospect. Normally she would be glad to get a haircut. It turned out she was tired and wanted to go home. We had been away from home since 10:00 this morning. As it turned out, I was wrong. When we got to the salon for our haircuts, we found out that they are really scheduled for next Tuesday. Thus she got to spend the balance of the afternoon (almost a full 3 hours) at home before we went to dinner. I have tried not to over schedule in the past, but this experience confirms just how important that is. She likes to have breaks at home and by herself (I think). I need to make sure she gets this time while also trying to minimize her boredom. It turned out that going to Panera, having lunch, and then seeing a movie was all she needed. It was time for a break, and she got it.

I continue to be surprised at some of her confusion. Yesterday, for example, she had gotten up from a little nap in her office. She came into the kitchen for something and was going back to our bedroom and asked, “”Do we have an iPad?” I think that she was momentarily forgetting that she has a new iPad to replace the one that was stolen last week.

Fighting Colds

A little over a week ago we both came down with colds. That has captured our attention since then. Although Kate has had a more serious cold, I have also taken longer to come back than I normally do. It is a little difficult to assess how her Alzheimer’s has affected her behavior during this time. What I can say is that she has been more vocal than usual. By this I mean that she has moaned and groaned a lot as well as expressing vocal sighs and “ohs” during coughing bouts and other moments when the congestion in her throat and nasal passages increases.

Her typical Alzheimer’s symptoms have continued, but I have paid less attention as my focus has been on treating my cold. I have been drinking water all day each day. On Tuesday (2 days ago) I received 2 new SONOS wireless audio speakers. This made for a good time to set them up in the family room (less than an hour) and listen to a variety of music from my own CD collection as well as streaming from Amazon and Pandora. Yesterday I ordered a subwoofer to add to the system. It should be here by Tuesday or Wednesday of next week.

It has also been a good week to gather income tax records for our accountant. I am pleased that I have assembled 90% of what I need. I still haven’t received everything.

The one thing I have noticed today is that Kate sounded unusually annoyed with me. It occurred around the time we were to go for our haircuts. I think this is a holdover from the times when I have rushed her. It seems that every time we get ready to go someplace, she seems to be annoyed.