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Mini-meltdown; others to come?

In my previous post, I gave an example of how well Kate is adapting to situations in which she finds her AD keeps her from doing things as easily as she could previously. Last night we had an example of just the opposite reaction. After I got home from Dad’s last evening, I poured Kate a glass of wine while I warmed up some quiche and cooked an onion for our dinner. She was working on her computer and didn’t get around to drinking any of the wine. (This, by the way, is another characteristic I am noticing. She starts on something and completely forgets about doing something else.) About the time I was going to bring the dinner into the family room, she closed her computer and was putting it away when she knocked over her wine on the table beside the new love seat we got in late August. She went ballistic. I rushed in with a towel and soaked up the red wine all over the table. It turns out that her concern was not the table but the love seat. Wine had dribbled down on the arm and then on the seat. We worked to soak it up and got most of it. We will have a permanent stain to remind us of this event. During the cleanup she was quite disturbed. Finally she said, “”I am such a disaster.” I told her that she was not. She said, “No, I am a disaster. I am going to make your life miserable taking care of me.”

As her condition continues to deteriorate, I can’t help wondering if this is something I am going to see more of. For her sake, I hope not. Once again, this is a good example of the frustrations that an AD patient experiences even as others fail to see that she has AD.

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Busy Day

Yesterday was a Monday which is usually a routine kind of day. Here’s what actually happened. I got up and went to the Y as usual. Before leaving, I asked Kate what time she was to meet our neighbor to go for a walk. She told me 9:00 a.m. I reminded her that we had a funeral service at 11:00 and that she should meet me at the office at 10:30.

I received a call from her shortly after 10:00 asking if I could come home to get her instead of her meeting me at the office. I told her I would do so. When I got home she was quite flustered, and I told her to relax. She asked how long we had before leaving. I said, “Seven to 8 minutes.” Back into panic mode. She was also upset that she couldn’t find her slip. She remarked that she couldn’t ever remember where she put things. This is once again a reminder that the person with AD experiences much frustration and probably a lot of frustration that is never recognized by other people – even someone as close as a husband. I see the frustration on occasions like this, but I am confident there are many more that I never recognize, many of them that occur when I am not around or that she doesn’t mention.

We got away in about 10 minutes. I put on the second movement of Brahms violin concerto. I consider it one of the most relaxing pieces of music I know. I asked if she had taken her walk, and she said she didn’t want to talk about it right then – that she might feel comfortable talking about it later.

We got to the church in time. Before leaving I thought it might be good if we went to lunch together instead of my going to Rotary at 1:00. She liked that. At lunch, she asked if she could have a glass of wine, and I said yes. We both had a glass. We took our time before going to the buffet. During that time she told me that she had called the neighbor to tell her she would need to take a shorter walk in order to get to the funeral. The neighbor told her to come by her house to get her. Kate couldn’t find her house and then got confused about how to get back home; so she never got to walk. She called her when she finally got back home.

At any rate we turned the whole thing around into a very special time for the two of us. We had a leisurely meal in a quiet place and let the worries drift away.

Other things were also going on this day. I had received a call from a hospital client on Friday asking me if I would interview 4 patients who had undergone bariatric surgery. I agreed to do so. My contact was to email me right after we spoke with information on the location for Tuesday morning (today) as well as an agenda for the interviews. I still had not heard from her when I left the office around 10:15 am. Late in the afternoon I picked up an email sent at 1:00 with location and times. Even later I got the interview guide.

In addition, I had talked with the admissions office at Mountain Valley on Friday about moving Dad from Hall 100 to Hall 200. She was supposed to call me yesterday morning. I called her, and she said she would get “right back” with me. She never called. I called near 3:00 p.m.The person with whom I had sphad gone for the day. The person I spoke with this time agreed to let me make the move even though the staff that handles moving would be gone for the day.

I went to Mountain Valley right away and took care of the move. It went smoothly. Dad has a new roommate that may work out better than the one he left simply because the old one stayed in the bathroom for an hour or more at a time. The new roommate appears to be a dementia patient who is not communicative.

Dad, by the way, has not fully recovered from his fall a couple of weeks ago. He seems more confused and less like himself. He is eating reasonably well and is able to talk with you all right except for not hearing well.

On top of all this I am also mentally preparing for 8 weekly meetings with a small group I am leading at the church. We start tomorrow night. This will not be hard. It is simply a responsibility that I am not too eager to undertake at this time.

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Sometimes You Just Can’’t Win.

It has been almost two years now since Dad has been at Mountain Valley, a rehab and skilled nursing facility. During that time I have tried numerous ways to make life easier or more pleasant for him. Often I have been successful. The best things have been his birthday parties and going out to eat. On the other hand, there are quite a few little things that have failed. Early on he found he was unable to see the TV; so I bought him a table-top radio with a cd player. I found he couldn’t see well enough to work the controls. In a short time he had knocked it off the table and broken it. After that I tried a small transistor radio that was a real gem. I got ear buds so that he could listen to anything without disturbing anybody. That failed quickly as well. He could never work the controls and then broke the antenna.

There is no need to attempt a recitation of the many other things I’ have tried, but this week I found another issue. Dad got a new upper plate in the past 30-45 days. He complained that they wouldn’t stay in properly while he was eating which made it difficult for him to eat. I bought him some Fixodent and have been using it each afternoon when I visit him. He had mentioned, however, that he didn’t know where it was kept; so he was unable to use it at other times when I was not there. I put it in his top drawer and, unfortunately, assumed that either a nurse or CNA would help him. Yesterday afternoon when I arrived, he reported that his teeth were hurting him, specifically the roof of his mouth. He wanted to take his teeth out, but I said we were going down to the dining hall and thought he should wait until after eating. When we got to the dining hall, he complained again and I took out his teeth. When I did, I discovered that there was an enormous amount of Fixodent in the roof of his mouth. It turns out that he had applied the Fixodent himself and got too much. After that he didn’t feel like eating; so he didn’t touch anything except the soup I had brought him.

About 15 minutes ago he called to say that the roof of his mouth was very sore and that he couldn’t even eat a banana that I had left with him yesterday.

The point of all this is to express the feeling that many times I (and I assume other caregivers) can’t win. In fact, Dad is like a bull in a china closet. He can break almost anything around him. He is regularly losing things and always blames the staff. I am sure the staff is sometimes to blame, especially in the loss of things like his teeth and cell phone. At least twice his cell phone has been taken to the laundry. The same with his upper plate. On the other hand, Dad in his condition is hard on things.

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Caught Between Father and Wife

This afternoon after we returned home from church and lunch, Kate encountered a frustrating situation that I suspect will either become more common or she will adapt to avoid such things. Either way life will change. Here’s the story.

She is working with a PEO sister in connection with a scholarship program. She has done this for a couple of years. This past year she found herself in an awkward situation when she failed to send in a candidate’s recommendation to the international PEO office. I don’t recall the exact details, but she ultimately sent the recommendation by FedEx but apparently gave the wrong address. She suffered no ill consequences except for some embarrassment for not having gotten the letter in at the time it should have been in.

A week ago the two of them met with about 10 new candidates for the upcoming year. Nominations must be in by June 15. They decided on two candidates their chapter would nominate and were looking for other chapters to nominate the others. They were scheduled to meet this afternoon at Bojangles to go over the details. Kate’s assignment was to simply type the basic information about each of six candidates. She had all the information on handwritten notes she had taken down at the time of the interviews.

I was in the kitchen while she was working in the family room. I could hear that she was frustrated. She finally asked if I could come and help her. As it turns out, I did very little but stay with her until she was finished. It took her a total of 3 hours to complete 3 pages of material. For the most part it was a straight copy from notes to the computer file. She is finding it very difficult to work with the new version of Microsoft Word and Windows 7. I can understand this as I am trying to do the same thing; however, she makes many mistakes that are in my opinion a direct result of her AD. She would delete information she shouldn’t delete. Her use of the program was so inefficient that she kept having to correct herself. That took more time than it should have.

She commented specifically on her inability to do the task. The real problem was that she doesn’t want to tell Shirley that she has a hard time doing this. That would be embarrassing and also might tip her off that she has AD. At one point, I tried to sympathize with her and said she would have to decline these types of things in the future. She said she knows that and was slightly annoyed at my suggestion. This is really hard. This is one of the things that others can’t quite imagine unless they have gone through it. Most people only think of the latter stages of the illness and believe that, as I have noted before, that the person with AD doesn’t know enough to experience frustration or sadness or any of the multitude of other emotions that go along with AD.

During the time I stayed with her as she was completing the task, she repeatedly said, ”Don’t leave me. You don’t know how much you are helping me.” For the most part, I was simply a source of security for her. I don’t mean to minimize the importance of this, but want to make clear that I did little in the way to actually organize the task or do it for her.

Since this occurred at the time of day when I would normally visit Dad, I did not get out to see him until she left to meet Shirley. I was a little anxious since Dad is sick right now, and I felt the need to check on him. It turned out not to be a problem. When I arrived, he was still asleep as he usually is. He had not eaten dinner. The nurse had checked his blood sugar. It had been 49 and 79 a little earlier. She had given him something to raise it. I told her to call me with any problems and that I was concerned about the low blood sugar.

It is now 6:35 pm, and Kate is not yet home. I expect her to be here any minute. We’ll take some time to be together and attempt to lower the stress level until the next time rolls around. This was the most serious situation since the problem with the letter of recommendation, but was similar to what was going on when she and her brother were working on a photo album on their mother’s family. I know Ken was probably wondering what was going on. One day he will know.

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Feeling Guilty

Once in a while I feel a little guilty about the way I respond to both Dad and Kate. Last night, for example, I had turned my cell phone on vibrate while we were attending our music club meeting. I forgot to turn it back to ringer when we returned home. This morning when I got up I noticed that I had missed 3 calls and had 3 voicemails from Dad – all around 11:30. He indicated that he was a little disoriented and was sitting on the side of the bed and could not find his call button. In his first voicemail, he said something about thinking he was in a kitchen somewhere. Although 99% of his calls involve no urgency or crisis, once in a while he needs something like last night when he couldn’t find his call button. Two nights in the past week or 10 days, he has placed 10 calls one night and 8 calls another. Most of these calls he doesn’t even say anything because he can’t hear anything said on my end. Nonetheless, I want him to feel that he can reach me when he is unable to get attention from the staff; so I feel guilty that I wasn’t available for him.

Similarly, I occasionally find myself not being as patient with Kate as I should be. In spite of her forgetfulness, she does remember a lot; so I tend to expect her to remember things that she doesn’t remember. The other day I asked her if she remembered some person or occasion from a few years back. She indicated that she had no memory of him/it and said, “”You forget I have Alzheimer’s.” Most of the time I do remember and don’t criticize or even point out her mistakes, but sometimes I give a response that shows I am treating her as though she does not have Alzheimer’s. I feel a tinge of guilt when this happens.

Late yesterday afternoon we went over to Panera Bread to get a bite before going to the music club. It was beautiful outside and we chose to eat at an outside table. We sat at the very same table we had sat at a few days ago. After sitting down, Kate said, “”This is the first time we have sat outside here.” I said, “”Do you want me to answer honestly?” She naturally said, yes.” I told her that we had just eaten outside a couple of days before. Then I felt guilty because I felt she had no choice but to say she wanted the truth but that giving her the truth did not serve any useful purpose.

The weekend was stressful. Kate had agreed to help with refreshments for Monday’s meeting of the music club. When she did this, I was concerned and suggested we purchase what we needed rather than prepare them ourselves. She felt she really wanted to make them herself. I notice there are a number of occasions when she wants to volunteer to do something like this when I think it is too stressful for her. It seems important to her, however, to retain as much of her ability to do things as she can. I can easily understand this, but what troubles me is that 1) I know I will need to help her and that will be difficult for me because they are usually things that are not my cup of tea and 2) she is going to be stressed in doing what she wants and has committed herself to do.

At any rate, as we go to the weekend, I told her I would go to the grocery store for her. Then I had to push her a little to actually get started with the cooking on Sunday afternoon. I was pushing especially hard because I wanted to accomplish as much as I could before going to see Dad and also because she wanted to attend a performance of Verdi’s Requiem Sunday night. She is very slow to move. This has been true for several years. In fact, she has never been sensitive to time. I now believe one of the consequences of Alzheimer’s is moving more slowly because the brain functions more slowly.

One of the first things that I noticed in cooking was that she let me take the lead in getting things done. That is very unnatural for us in that I am not and have never been a cook in the baking sense. Cooking meat on the grill is a different matter. Despite her wanting to do things for herself, when it gets down to getting it done, she has to depend on me. When she does this, I get the greatest sense of her having Alzheimer’s.

In other situations she does beautifully. For example, last night at the music club, I don’t think anyone would ever suspect that she has Alzheimer’s. She is able to converse quite naturally and confidently. It is only when she has to make her brain work – e.g., figure something out like quantities in a recipe the way we were doing Sunday. Sunday she put 2 cups of sugar in the crust for the lemon squares and the sugar was supposed to be in the lemon itself. Fortunately, the lemon squares were edible and people in general liked them, but the crust was crystalized sugar and not like it usually is. Before leaving the house on Monday morning, we tried to prepare praline cookies. I left just as she was putting them in the oven since I thought the recipe was simple and one she had prepared many times. It turned out that she had to throw away one cookie tray because she had overcooked them.

When we got home last night, she was able to unwind. She was happy that people had liked what she had prepared even if we did not think they were up to her standards. When we went to bed, she indicated that she was relaxed and did not plan to volunteer to something like that again. That certainly made me feel better.

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Stress, Frustration, Depression?

Kate does not talk in depth about her AD. She mentions it mostly indirectly and fleetingly. That is, she says something like, “”I just don’t know; I can’t remember anything.” Then she moves on. I have learned (mostly, anyway) not to push her to say more. She seems to want to be comfortable to recognize her AD but not to dwell on it in a discussion. She does make reference to the stress of life. She also seems down at times. I also note that there are related things that have nothing to do with memory. For example, over the past few years, she has been reading the newspaper less and less. Nowadays, she reads only infrequently. I think she is frustrated by not understanding what she is reading, but again, I don’t press her. I do sometimes joke with her about not being able to probe for more information about anything she brings up.

Another thing that has become next to impossible is operation of the DVD player or doing a number of things on the computer. I think one of the reasons she likes having me around is to be there to help her address the never-ending resolution of problems.

Yesterday she called me to say that she had forgotten another hair appointment. Neither one of us had written it down. Later she said that the message she received from her hairdresser indicated that she had forgotten to make a reminder call, something that is not routine but something she has started doing for Kate.

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Pain, Pain, Pain

This past Friday, Kate and I drove to Nashville where we had dinner with and old friend from Wisconsin and three of her friends. On Saturday, we got together with our daughter, Jesse, and her boys who were there for half-marathon on Sunday.

Overall it was a good weekend, but it was also a trying one for Kate After Friday night’s dinner, she commented on how people seem to ignore her and give their attention to me. She also expressed her fear that increasingly she feels uncomfortable in conversation. She has a special fear of asking things she has just asked which I have observed a few times. She says she sees herself becoming quiet the way she has seen other AD victims do.

She hasn’t wanted to talk about it, but I have noticed that she was low as we returned on Monday. She has my cold now, but I don’t believe that is the explanation. We were together for lunch, and I took her to a new ice cream shop downtown to give her a little boost. She seemed to enjoy it, but it didn’t really change things.

I should have entitled this entry (started this morning) as Pain, Pain, Pain. It is the confluence of several things at one time that makes it stressful. I am reminded of the Psalms. Many of them are written when the authors were on the mountain top. These sing praises to God and give thanks for all the blessings of life. Many others, however, are written from The Pit of despair. These focus on the challenges of life and often question where God is and appeals to God for help out of disaster. Though my own moods are usually upbeat, I have recognized in the past few years that external events can make it hard to feel optimistic. Right now is one of those times.

Over the past 3 years my business has been terrible. I have lost a lot of the money that I had made over many years. We are now down to 3 staff members. I recently sold the building to a law firm that will occupy the downstairs. We are going to lease the upstairs from them. Last week we made the move and like the new arrangement. However, in the midst of feeling good about selling the building and sensing that the new quarters suit us better, the business itself continues to decline. We just aren’t getting calls anymore. We committed to a one year lease thinking we would be safe because we have booked enough business to almost cover us for a year. It is so slow now that I am beginning to wonder if we were dreaming.

Now let’s add the events of the weekend and the following days at home. For me personally the weekend was great because we were with people we liked and enjoyed pleasant, stimulating conversation. In addition, we had the joy of being with Jesseand her boys. On the other hand, it was not as good for Kate as I pointed out above. She continues to recognize her deteriorating condition. I will SCREAM once again that for a good while AD patients know they are losing it. It is horribly depressing. I think it is especially depressing for people who value intellectual ability as Kate does. It is more than intellectual ability. It is also the ability to operate confidently in the world –, to be able to handle everyday things.

Last night we went to a movie called The Matchmaker at our local arts theater. After we left the movie, Kate said, “I didn’t understand it at all – even after you explained it.” I recognized that she wasn’t just saying that it was a confusing movie but that she was saying her condition prevented her understanding what was going on. When she says things like this, I can see the pain in her face. Then I don’t know what to say. I told her I wished I could help her and that I love her. I started to say more, and she stopped the conversation. This is a typical pattern. Things occur that lead her to say something acknowledging AD and her frustration. Then just as quickly she wants to move on as if continued conversation will only make it worse. I know the pain is greater for her, but it hurts me tremendously.

One thing that struck me and has on other occasions is similarity in my experiences with my dad. Yesterday afternoon I took my old iPhone to the ATT store and had them set it up for dad. When I tried to show him how to turn it on and make calls, he simply couldn’t do it. It was frustrating for him and for me. I had underestimated the difficulty for him. I had even set up a set of favorites to make it easy for him to dial. All he had to do after turning on the phone was to press the name of the person he wanted to call. It was next to impossible for him to do. So this experience was followed by Kate’s not being able to understand the movie that was not that complicated.

Seeing her deterioration over the past year, I can’t help wondering where we will be this time next year. We are planning to make a trip to the Galapagos in January. Will she be up to this? It was a bit of a chore getting her ready for the daily activities on the trip to Africa. Will it be impossible next year?

Yesterday morning, I saw Herman and Betty Snyder at Starbucks. Betty said she was going to call Kate and asked me if she would like to join a Care Team at church. I explored the responsibilities and told her that I thought she probably would not want to do it. When I spoke with Kate last night, she said that she might like to do it. This makes me wonder how realistic she is about things that she can undertake.

Our conversations involve references to future travel. I get the impression that she believes this is something that she will be able to do for a longer period of time than I think she will. Right now, for example, I am thinking the trip to New Zealand may need to be a cruise because it will be easier logistically.

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Everyday Problems Associated with Alzheimer’s

The past week has been a full one. We celebrated Valentine’s Day by attending a concert by the Knoxville Symphony on Saturday night, the Symphony League’s Valentine’s Ball on Sunday night, lunch at Casa Bella on Valentine’s Day, and the UT Symphony that night. These were good times for both of us and serve to remind us how much we can continue to enjoy despite Kate’s Alzheimer’s looming over us. We continue to put a special emphasis on our relationship which seems more precious to us with every passing day.

On the downside, on Tuesday morning Kate took a walk around the neighborhood with one of our neighbors, Lucy Grayson. During that walk Lucy commented on another neighbor and her husband, Barry and Mary Jane Winters. Mary Jane also has Alzheimer’s which we have been aware for 2-3 years. Lucy indicated that she felt sorry for Mary Jane and then said, “I feel especially sorry for Barry.”

These are the kind of things that occur routinely, but they have a special meaning when you also are plagued with the disease. It makes me think once again that people need to be more careful about what they say.

Kate and I had lunch together and then she left in her car to run a couple of errands before returning home. I received a phone call from her a little later. She left a voice mail as I was in a meeting or phone call at the time. The message was a bit garbled but I could tell she had had an accident of some type. I sent her a text and asked if she were all right. She answered quickly that she was; so I called to find out what had happened. She told me she was pulling into a parking space and misjudged the distance to the car on her right and had knocked out her front headlight. When I got home that night I discovered that it had not only broken the right signal light but had also damaged the front fender, the right front passenger door, the right back door which will not open, and the right rear fender.

We sat down and had a glass of wine and discussed the events of the day. That is when she told me about Lucy’s comments that morning as well as how she was feeling about the accident. We didn’t say much. It was obvious to me that she was shaken by the experience. It is just one further sign of her inability to do anything right. I try to reassure her when these things happen, but we both know her situation is getting worse and affecting lots of things besides memory.

Last night at Kate’s suggestion we built a fire, had a glass of wine, and brought in Chinese for dinner. It was a good time for conversation. We find a lot of our conversation relate to things we are thankful for. I think this is our unconscious way of counterbalancing the trauma of the Alzheimer’s. It was a very nice evening. One of the things she said when we talked was that she had lied about something and wanted to explain. She went on to say that she had indicated on Tuesday night that she had not been bothered by Lucy’s comments, but the truth was that she had been bothered by the comment that Lucy felt even sorrier for Barry than for Mary Jane. She didn’t say this, but she doesn’t want to be a burden on me.

On a slightly different note, many decisions are influenced by Kate’s condition. For example, I have been planning to buy a new car next year and thought that I might even delay a little longer. My idea was that Kate may not be able to drive much longer and that I might trade in both cars when I buy a new one. This changed this week when I have significant repair bills on my car and have decided that I should buy a new car now. Kate asked me if I were planning to pass her car along to me. I told her I was not as it had so much more mileage than hers. I got to thinking later that she might have been thinking that her station wagon was getting to be too much for her and that she might do better with my car. Now I am beginning to wonder if getting her a smaller car might be an intermediate step. At the moment, I have decided against that.

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Stressful Times

We’ve had a couple of stressful weeks following our trip. We still have to finish up an irrigation leak in the front yard that we identified before leaving, Kate got a cold that has lasted until the last day or two, her computer went out, and we bought another, Dad’s heart rate dropped to 30 and he went to the Heart Hospital for a couple of days, business is off and I have been deciding whether or not to close entirely, we’ve had a buyer for our building and settled on a contract, etc.

Kate seems to have felt better this week although she was a little upset with herself this morning as she prepared to get ready for a PEO Founder’s Day luncheon. She couldn’t remember the exact time of the lunch and waited too late to find someone at home who could tell her. Then she lost a magnet for the back of her PEO pin. She found it but said, “”I’m a disaster.” At 12:06 she asked me what time it was. I told her. and she thought it was earlier; so it meant that she was late for what turned out to be a noon lunch. I drove her which reduced her stress and told her I would try to take her places whenever possible.

The good news is that selling the building will take a little financial pressure off of us. In addition, Megan figured up the committed projects and our part of the income. It turns out that we almost have everything covered for the year. All we need is another 4-5 average projects to get that; so it looks like we will make it another year. That’s good because we agreed to sign a one-year lease with the new owners of the building..

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One Year Since Diagnosis

One year ago today, we met with Dr. Reasoner to receive the news that Kate’s results showed she has AD. During that year I have noted apparent declines in her memory, sometimes not quite sure whether the changes were real or not because they can be so subtle and similar to what we all do. At this point, there is no doubt that she has declined in a perceptible way.

A week ago last night we got back from our trip to Africa (Tanzania) with OAT. It was a great trip that we both enjoyed far more than anticipated. On the other hand, I felt as though I had to be watching and helping her every step of the way. I am having to assume more and more responsibility for everything.

She continues to get along well in normal interactions with people. I don’t think anyone on the trip would suspect her condition. Neither do I think our children or close friends suspect. I do sometimes wonder about her best friend, because she and Kate have had so many opportunities to talk and socialize together.

The most distressing thing to me is that Kate is so frustrated over her inability to do many things that she would have been able to do before. In the last 2 days she has commented that it’s the little things that bother her the most. From my perspective that would include things like remembering how to charge her cell phone or how to deal with a technician on the help line. She has great difficulty following a set of instructions. They simply overwhelm her. In our personal conversations when she indicates a problem and I automatically try to explain, she stops me because she can’tunderstand.

The whole situation makes me recall times when I hear people say something like, “Well, at least she doesn’t know.” I heard this when my mother was in the early stages. Kate is keenly aware that her memory is declining. She sees how much of her time is spent looking for simple things like car keys, her purse, etc.

It has gotten so bad that I feel I can’t depend on her to do anything. I either have to do it myself, or follow her to see that it is done. While on the trip, she picked out a bag to bring back to Doris. We bought it along with a couple of other things. Then after eating lunch (this was in our lodge) she went back into the gift shop. I saw her looking at the bags again and asked what she was looking for. She told me she was looking for a bag for Doris. She had not remembered buying the first one only 45 minutes to an hour earlier.

She is clearly discouraged. She is not sleeping well. I am not sure, however, how much is a result of jet lag and how much is anxiety over her condition. I think it is some combination of both.

Over the past year, I have cited specific instances of her memory failure. I suspect I may do less of that as so much occurs that I can’t recall the instances without writing things down at the time, and I find that impossible.

We enjoyed the Africa trip so much and are looking at possible trips to New Zealand, the Galapagos, Russia, and China. I fear, however, that our travels may be heavily influenced by her condition. Right now, for example, I am thinking of taking an OAT trip to New Zealand next January (2013), but I wonder whether or not that will be a good idea. I do believe we could do a cruise, but half of the time is spent on the water. I will wait until later in the year to see how things are going.

I need to be honest about my own anxieties. This is a very trying time for me. My business is so bad that I had to let Regina go before Christmas. She had been with me for 28 years. Now I am wondering how long I can keep the doors open. Dad requires attention. This week he spent 2 days in the hospital. I am spending less time in the office. I need to spend more time with Kate. It is a difficult time. I am not sleeping as well as I used to.