24 February 2013

Carpe diem

MARIE: As we’ve said, with the duodopa pump comes better symptom control, and with that comes a greater freedom and eagerness to participate in life. And boy, do we participate. Although Jon’s PD is better controlled now and he has almost gotten rid of the debilitating OFF states, Parkinson’s continues to nag at us to make the most of now, because you never know what’s round the corner. Could be more good, but could equally well be another downwards slide, new symptoms, drug intolerance, whatever. So we are seizing the day and carping the diem.

First, of course, was the trip to the UK that I told you about in the last post. Then last week we had a visit from two UK friends with Parkinson’s – enormously enjoyable for Jon as he turned the best room in the house into a huge electronics workshop for the duration. Also much talking, walking and eating. Sightseeing not so much, as it’s no mean feat to get three Parkies to feel up to an excursion at the same time. On the other hand, that was perhaps also the joy of it: that there was no need to pretend or to push oneself as everyone except me was in the same boat.

Next week we get a long visit from Jon’s oldest friend, and I shall take the opportunity to nip out for a few days. I’ve asked for the home nurse to come and help with pump matters morning and evening, but in between the two of them will be on their own. I think they can do it, and that Jon is eager for the independence of a few days without my constant presence. We’ll let you know how that goes.

After that comes a short visit from another foreign friend, a two-week period of staggered visits from the family to celebrate Jon’s big birthday, and then we’re off to a pump users’ meeting in a different part of the country so will take the opportunity to make a small holiday of it. Then my parents come down for the soon-to-be traditional month of hard gardening labour, we must organize a visit from our good Dutch friends, we’ve got another two domestic holidays booked and are planning another UK trip, there’ll be an invasion of nephews at some point, and also my equally big birthday later in the summer, and…and…and…

Looking at our schedule, I am torn between despairing at the amount of stuff we have planned – how on earth am I going to find the time to write the next book? – and on the other hand thinking that this is exactly the reason why I don’t go out to work: so Jon and I can squeeze every last drop of good out of life while there’s time. I may not go out to work, but I still struggle to find the right work-life balance.
 
On Jon’s part the issue is more straightforward. Yes, he has gotten rid of the horrible OFFs, but he still has unpleasant dips in his general state. These he can counteract by taking an extra dose (using what we call the ‘happy button’ on the pump), but the ideal time to take it is just before he needs it. That means he’ll have to learn to predict which activities will deplete his dopamine levels so he can act early and avoid even the smaller dips. He had quite a bad dip last week when he went out bowling with the Oak House guys. The fun of it carried him through until he had run utterly out of dopa, and it took him quite a while to get back in the saddle. But he’ll learn, we’ll learn, and meantime life is still a whole lot better than it was.

07 February 2013

Travels with the pump

MARIE: We’ve just had a long weekend in the UK – partly to see Jon’s daughter’s new house (and family and friends, of course), and partly to test out traveling with the duodopa pump. We were both mildly apprehensive. Would we be believed by airport security when we told them that Jon now has a tiny metal part inside him and can no longer go through the scanner? Would they accept that we carried all Jon’s gel form medication in hand luggage? No way would we ever let drugs go in the suitcase, a delay or misdirection of luggage with drugs doesn’t bear thinking about. Would the drugs stay cool in their special thermal bag for the duration of the journey? And would the hotel be able to keep the drugs cool for us, yet allow easy access to fresh drugs in the morning?

I am so happy and relieved to say that the answer to every one of the questions was a clear YES. Apart from having to carry the thermal bag around – which would be quiet heavy for a long trip – travels with the pump are significantly easier than travels with pills. Going across time zones? No problem. We used to try and stretch or compress drug timings on travel days to fit both with time zones, long days, and urgent bursts of activity. Now, the meds are just constantly flowing, there’s no need to plan or discuss anything, Jon just presses the lovely extra-dose button, and off we go. Put the pump on in the morning, take it off at night, and don’t worry about a thing in between. Oh, the relief. It’s wonderful to know that we’ll be able to travel by air again without any anxiety.

Two more things helped make the trip a success. It was clear on our last trip to the UK that the whole business of travel and any lack of home comforts at the destination really wears Jon out, to the point where he hasn’t the energy to enjoy the purpose of the trip. So this time we broke it up. We flew over, but instead of getting the airport train and then waiting for a ride and then having a social situation, we simply checked into the airport hotel and stayed the first night there. We’ll definitely do that again, it’s now vastly better to have two unstressful travel days rather than one demanding one.
 
And the other thing that helped was that we swallowed all pride and asked the family for help with lifts and a really comfortable place to sleep. I have regularly suggested to other carers that they should ask for help from their families instead of waiting for people to guess at how they can help, but I’ve not been good at taking my own advice. I was really quite overwhelmed at the generous help and consideration we got on this trip, the trouble they were prepared to go to in order to give Jon the best basis for having a good time. Which he most certainly did, as did I. We’ll be back, as he’s taken to saying.
By the way, it was funny to note how un-embarrassed we have both become. This was the first time the family had a chance to see the pump and Jon’s extra orifice, so he prepared to do a little show-and-tell. I’m not sure if it was discretion or a slight squeamishness on the part of his audience, but that didn’t take long at all. I guess by now Jon and I are so used to the evidence and paraphernalia of disease that we don’t think of it as anything out of the ordinary. Maybe we need a little reality check.