Wednesday, October 26, 2005

Update 10/26

Hello All—

The psychiatrist came on Monday to evaluate Kari and basically just asked her a few questions for 10-15 minutes.  He then went and talked to the doctor, whom I talked to at length after their meeting.  The psychological analysis wasn’t really anything that we didn’t already know: that Kari, while alert enough to know where she is and who is around her most of the time, is experiencing a kind of delirium where she often sees or experiences things that are not happening, such as seeing someone in the room who is not there, is not able to choose the right words to convey her meaning, and experiences a high level of anxiety.  He was very clear that this was NOT a form of dementia and that Kari did not show any of dementia’s normal signs in his diagnosis or in the brain MRI that was performed a few weeks ago.  The basic difference between dementia and delirium is that dementia occurs when brain cells are actually damaged or are dysfunctional, such as in Alzheimer’s or stroke patients, where as delirium is a sudden change in mental status resulting in confusion or abnormal behavior.  Also, we are not any closer at this point to figuring out the exact cause of Kari’s mental state.  The only thing that we can point a finger at as a factor would be a severe lack of sleep and extreme pain, which is what we were already thinking.  The psychiatrist did suggest that the doctors take Kari her valium and her three sleeping medications along with the risperdal (her anti-psychotic) not because he believed that these medicines had anything to do with the cause of her delirium, but because it can be very hard to evaluate a drug’s effectiveness when it is being given with a combination of other drugs.  Also suggesting that this was not induced by drugs was that none of Kari’s meds were changed prior to her slipping in to her current mental condition.

That evening, they made the changes to here drug sheet and started her on Ziprasidone, another antipsychotic that has sedating properties.  The feeling was that they could get both effects from one drug and then would be able to evaluate its effectiveness.  So far, nothing much has changed.  Kari did not sleep at all Monday or Tuesday night, and from last night into today, she seems to be having increased anxiety, mostly about things that are not actually happening.  She always seems to be more relaxed during the day, so yesterday we tried to keep her from sleeping so that she would sleep at night.  Because that didn’t work, today we are letting her sleep when she wants—there is no guarantee that she’ll sleep at night no matter what we do.  The doctors expected that there would be an adjusting period to the new medication and going off the valium and sleeping medications, but also admit that she is one of the most puzzling cases they’ve dealt with.  I think at this point that it is fair to say that it is impossible to make any clear judgments or conclusions about what is actually happening.  There is no consistency with anything.  It’s fairly obvious to me that most of her thoughts and the things she panics over are simply random places her mind is going—sometimes they have a link to reality, sometimes they don’t.  Is there significance to what she says?  Maybe, but to try to figure out any type of meaning from it will inevitably be inaccurate and ultimately be only a frustrating exercise.  Simply because something works once doesn’t mean anything for next time.  At night when Kari is having bad anxiety or spasms, I’ve tried just being ultra calm and soothing, I’ve tried “tough love”, the logical approach, distraction, any combination of the above and also just plain ignoring her.  Every now and then one will work, most of the time they don’t.  So the general plan here is to keep trying to get her to relax and sleep.  We don’t have a time frame for when we think she’ll come out of this, and the nature of delirium makes it hard to figure out its exact causes.  The bottom line is that we need to get her to rest both mentally and physically.  Sleep is pretty much the only thing that should work for her—we just haven’t figured out how to get her to do it.

15 comments:

Anonymous said...

Thanks for the more accurate update Aaron.You have a good grasp on what is happening--and God bless and keep you. Me

Anonymous said...

Dear Aaron and Kari,
I am so sorry all of this is so
hard. I pray you will be given
new strength with each new day.
Your dad and Linda have a very
different approach in how they
see and handle kari. Over and over
I read the blog and see the countless times they have been able to help Kari in a way that seems to make sense to her, or give her peace. Both of them are of value, and they love you both very much. May Jesus give you both the peace that only he can give

Anonymous said...

"It won't always be like this"

Kari Morris-Guzman said...

Hello--

I would like to know who posted the second comment that starts "I am so sorry all of this is so hard.." If you read this, email me at weloveyoukari@msn.com or simply post your email address as another comment.

Aaron.

Charlie + said...

Dear Kari + Aaron,

I am encouraged by the psychciatrist's move with the medication. Even though it seems many meds are being subtracted, the one he is using is "cutting edge" for that class. Actually, I was offered it with in the last year, but we went with a different one in the same class and generation. That class tends to break in quickly. I continue to have faith, hope, and confidence that soon after even a couple of days of good sleep / rest, Kari may seem sedated to some extent when awake, but I expect you will see some "clarity" in her thinking we have all been praying for...

Love/Peace/Strength,

Charlie +

Anonymous said...

I am so sorry all of this is happening! Friends at church and I have you in prayer everyday. I pray that Kari will be healed phisically and mentally. Trust in God an he will get you through this (Proverbs 3:5-6) even when it seems like things aren't getting any better. I send all my love!

kathy timmers said...

Dear Kari, Aaron and family,
I received the following in an email this week, have read it a dozen times or more and wanted to share it with you. What powerful, beautiful imagery- that our God never takes His eyes off us and sits lovingly and patiently in front of the fire. My prayer for you today is that you feel His presence in a mighty way as you are held in such a "hot spot".
Love,
Kathy

Malachi 3:3 says: "He will sit as a refiner and purifier of silver."

This verse puzzled some women in a Bible study and they wondered what this statement meant about the character and nature of God. One of the women offered to find out the process of refining silver and get back to the group at their next Bible Study.

That week, the woman called a silversmith and made an appointment to watch him at work. She didn't mention anything about the reason for her interest beyond her curiosity about the process of refining silver. As she watched the silversmith, he held a piece of silver over the fire and let it heat up. He explained that in refining silver, one needed to hold the silver in the middle of the fire where the flames were hottest as to burn away all the impurities.

The woman thought about God holding us in such a hot spot; then she thought again about the verse that says: "He sits as a refiner and purifier of silver." She asked the silversmith if it was true that he had to sit there in front of the fire the whole time the silver was being refined.

The man answered that yes, he not only had to sit there holding the silver, but he had to keep his eyes on the silver the entire time it was in the fire. If the silver was left a moment too long in the flames, it would be destroyed. The woman was silent for a moment. Then she asked the silversmith, "How do you know when the silver is fully refined?"

He smiled at her and answered, "Oh, that's easy -- when I see my image in it."

If today you are feeling the heat of the fire, remember
that God has his eye on you and will keep watching you until He sees His image in you.

heather velloff said...

Aaron~
My family and I are praying with you that Kari will get some much needed sleep very soon. I can't imagine the frustration of trying so many different things without getting any consistent results or making any sense out of things. Nevertheless, I continually have faith that God will heal Kari and I thank God for you, Aaron, as you tirelessly help her through this.
God Bless,
Heather

John said...

Aaron:

Thanks for another informative update. I was somewhat concerned when I read about dimentia. I have a friend who has a parent who has been diagnosed with it so I became somewhat alarmed by it in a previous post. Thanks for clarifying that it was not the case with Kari.

Cyndi and I are looking so forward to seeing you guys next week.

Love you both...and Cubs still rule!

John

Uncle Don said...

Dear Aaron,
I know this is a time of frustration for you but I also know from experience that Jesus never fails and His grace is sufficient for every time of need.
Having been through many years with an alzheimered wife I know well the frustrations etc. Also, through it I received great Grace, I learned patience, which I never had much of before, I found it best in my case to be gentle and kind, never to fuss at her and never to laugh at her mistakes. This helped me through all those long years.

Our prayer is that God will enable you to have an understanding heart and mind, the grace of God to be gentle and loving, the ability to stay the course untill God takes one of you home. Standing true to those vows made in marriage is a great thing that, at times, takes much courage and help from the Lord.

Know we love you even tho we are not well accquainted. Also, Aaron, we pray daily and often for both Kari and you. God is good. God loves you both and so do I.

Uncle Don

Anonymous said...

Thank you, Aaron for your update on things! I pray for strength and peace for you and REST, REST, REST for dear Kari!

Anonymous said...

He keeps me functioning each and every day. Without Him, I will be nothing. But, with Christ, HE strengthens me. (Phil 4:13)

Anonymous said...

Is there an update missing? I wanted to reread the one about the nurse probing Kari about her fears and how Kari rested after that. Which day was that?

Charlie + said...

Dear Anonymous, Kari + Aaron,

Anonyous, you said
>
Is there an update missing? I wanted to reread the one about the nurse probing Kari about her fears and how Kari rested after that. Which day was that?
>
I didn't see that the first time. I would love to look at that, to. Sometimes these blogs have issues.

Love/Peace/Strength,

Charlie +

Anonymous said...

I also wanted to re-read that most interesting blog about the probing of Kari's fears and Kari beginning to voice them out loud. The nurse seemed to connect with Kari and seemed to be helping her meet her fears.

As I remember the blog we saw was written by Aaron's dad, Richard Guzman (what an amazing writer and communicator!!). I believe it was dated between the 10-22 and 10-26 blogs written by Aaron. It must just be hidden somewhere but you know how computers are - it could have actually disappeared. Aaron, would you be able to find it and make it visable again so we can re-read it? Thank you so much.

I pray that God gives both Aaron and Kari Peace of Mind and Comfort of Body. God be with you and your families.