Monday, December 29, 2008

Putting Things in Perspective

My former pastor and I are almost the exact same age, but his parents are a little older - nearing the 80-year mark, while my mother is not quite 70. Lately, John's parents have begun experiencing some serious health issues, and his mother underwent a colonoscopy shortly after Thanksgiving. This led to emergency surgery the same day to repair leaks in the colon - and ultimately remove a portion of the colon AND her gallbladder. From there, everything seemed to go wrong. Her kidneys didn't function well after the surgery, which led to fluid and infection around the heart and lungs. She was placed on dialysis to reduce the fluid and assist her kidneys in removing toxins from her system. THEN, the week before Christmas, she developed more pain - SEVERE pain - that resulted in another surgery - this time to remove MORE colon that was septic and full of colitis, and to do a colonostomy. A third surgery was done to give her a tracheotomy to aid in breathing and a feeding tube. This little human dynamo has become a frail host to more tubes than the kids can count at times, and her survival has been in question more than once in the last couple of weeks.

Through all of this, the children (son John and daughters Debi and Beka) have kept vigil along with their little daddy, a retired Methodist minister who is not altogether well himself, but obviously faring better than his dear bride at this point. One of my pastor's sisters is also a Methodist minister - and the mother of two little girls, ages 8 and 10. Beka and her husband, Len, uprooted the family from Ft. Worth, Texas, to come to Hot Springs, Arkansas, and celebrate Christmas there while making trips to the hospital for ICU visiting hours.

Beka has kept the family updates flowing via a CaringBridge site (
http://www.caringbridge.org/), which has been tremendous for those who know the family and want frequent reports, along with a way to respond and share thoughts and encouragement in return. Beka has a tremendous wit, just like her brother John, and she has truly shone in her conveyance of how it is to cope with a mother who was at death's door, an elderly father, and two small children who wonder if Santa Claus will find them in another state. AND... she has found time and strength to minister to other families who were waiting in the ICU... proof that in the worst of situations, God can still use us if we are open to His will.

Here are a few of Beka's more poignant observations - and one truly hilarious incident... I am sure many of us can relate...

  • If I could only bi-locate it would be no problem. But I have yet to learn how to be in 2 places at once. Len and the girls are driving in tomorrow, and I don’t know how I’m going to spend time with the girls while also being at the hospital. I bought the girls their presents last week when I was home. We are going to put up a tree for the girls to decorate, and our aunt and uncle sent a turkey. So I think that is set. It’s just the bi-location thing that has me worried.


  • We are having a good Christmas day – much better than we thought we would given Mom’s condition a few days ago. We are pleased at her progress. Dad has a lot of us here at the moment and is enjoying it.


  • We were late to the ICU afternoon visiting hours because Dad is in the habit of helping people, and he can’t bear not helping. At the post office where we stopped to pick up Mom and Dad’s mail on the way to the hospital, there was a young woman who had locked herself out of her car and her lights were on. She didn’t have a cell phone to call anyone or money for a locksmith. At first I couldn’t believe that my frail, distressed, almost 80-year-old father was out in the rain trying to help this young woman while we were trying to get to the hospital.

    There were lots of other people – many of them young and energetic who did not appear to be on the way to the ICU - who might have helped. But of course, Dad couldn’t stand not helping, and the fact is, no one else was stopping to help her. So Dad asked her if we could call the police to unlock her car. (He actually said, “Ma’am, if you aren’t in trouble with the police, we’ll call them and they can help you unlock your car. Is that okay?”) We called them, and they were driving up as we left. His deep impulse to altruism can be inconvenient and, at least today, a little frustrating, but I wouldn’t have it any other way. That’s who Dad is. Mom has always put enough money in Dad’s wallet each morning so that he would have a little money to give away, but not so much that it would mess up their finances. She planned for his altruism; suppose we have to the do the same.


  • I promised that I would tell about a man who was on the same floor as Mom in the hospital that first week when she was in a regular room. This is a true story. He is a good natured, if challenging, little guy whose voice reminded me of a combination of Festus (from Gunsmoke days) and Grandpa McCoy (from the real McCoy’s). It was impossible not to notice him because when he was in a regular hospital room he would always (and frequently) yell for the nurses instead of pressing the call button. And when he wasn’t watching CNN, dance shows, or the children’s program Dora the Explorer, he often stood in the door wearing only a diaper – except for those few times when he forgot the diaper and displayed himself in all his . . . not so glorious form.

    He sometimes could not find his own bathroom, so would knock on Mom’s door and ask to use hers. My sister -- always polite – would show him back to his room with its own little bathroom. One afternoon my brother, other family members, and I were standing in the hall when this gentleman came to the door in his diaper and asked if any of us were nurses. My brother explained that we were not nurses and said to the man, “You need to find your button.” The man turned around, bent over, put his finger to his backside and yelled, “Buddy, I know where my butt is!”

    As the nurses were escorting him back into his room, he yelled, “That boy wanted to know where by butt is. I know where my butt is.” He turned back to John, “Why do you want to know where my butt is? Bud, go find your own butt.” My brother, who like most United Methodist pastors has had lots of training in sexual misconduct and knows not to comment on people’s butts, stood in the hall saying over and over in a calm voice. “Sir, I am not at all interested in your butt.” The little old man is no longer my mother’s neighbor and the hospital seems dull, if more peaceful, without him. Let's hear it for peace and quiet.


  • Our sweet father continues to be a challenge. When there are men around (his brother, son or son-in-law), he will let them park his car. But he doesn’t want his daughter dropping him off and picking him up in front of the hospital and parking his car. When I ask him to let me do that he always says, “I am the papa” (which translates “no.”) Yesterday when we were walking in the rain to his car as he was stepping over tree roots, sunken places in the grass, and two curbs, I tried to convince him to park in the handicap parking spaces from here on out. They are a lot closer, and the path is handicap accessible from those parking spaces to the hospital door. Because of the lupus and arthritis and whatever else, he has a handicap sticker and can rightly use those parking places. But he has so far refused to park there, because, as he explained to me, “What if some old people came and needed those handicap spaces?“ (!!???!!!)

    I may have now convinced him on the grounds that if he falls and breaks his leg (as he did last year), it will be a hardship on the rest of the family and he won’t be able to care for Mom. Basically, he will only agree to park there if we can convince him that it is selfish not to! Before the emergency surgery Friday before last, we had a good way to convince Dad to do whatever it was he needed to do (take his medicines, take his nap, eat regular meals, etc). We would say, “We are going to tell Mom on you.” It worked every time. With Mom out of it, we don’t have anything over Dad. We need her fully conscious again so we can have greater leverage.

    He does on occasion get tired of being bossed around by his children. Several weeks ago, I asked Mom and Dad to take a moment each day to find several things for which they could give thanks to God. The first day, Dad said that he was thankful, among other things, for his children. The next day, fed up with us, he thanked God that he and Mom stopped at only three kids. He couldn’t have survived any more than that. (Although when you count the original 3 and spouses, they now have 6 and we've all been a part of the healing process) Our daughters Anna [10] and Katherine [8] have told me, “You better be careful, Mom, or Mammaw and Pawpaw are going to put you in time out.”


  • Dad just took the girls, Len and I out to eat at Dixie Café, and we are all sitting in the living room at the moment reading or working on computer. (Len is reading the New York Times on his phone, Katherine and Anna the funny pages, and Dad his science fiction paperback book.) It is uncharacteristically quiet. Dad will head to bed soon. The girls have had had their baths and have put on their pajamas. I’ll read bedtime stories to them shortly, and Len will head to the hospital in a little while for the 8:30 to 10 visiting hours.

    One of the gifts of the visiting hours in ICU has been that we’ve had large blocks of time for prayer and reading scripture. It’s a powerful thing to sit with a sibling or my father or husband and lay our hands on Mom and pray together for her. And it has been a joy to read scripture – especially when Dad joins in on the ones he knows by heart.

    I’ve read to Mom from the Psalms a lot lately, including these verses from Psalm 27: “13 I believe that I shall see the goodness of the Lord in the land of the living.14 Wait for the Lord; be strong, and let your heart take courage; wait for the Lord!”

Friday, November 21, 2008

Ahhhhh... Technology!

Last week, my grandmother told me that the TV in her bedroom didn't work. I went into her bedroom and turned on the TV. "No," she said, "it's the remote. It won't work." I looked at the batteries - AAA's - and told her maybe they needed to be replaced, and I would get her some more. However, I had just been to the store to do her shopping, so I told her I was not returning that day... but soon. Meanwhile, I determined that the new universal remote control we got a few months ago for her living room television would also work on her bedroom TV. So I told her to carry it with her when she went to bed at night and use it in both rooms until we could return with batteries.

Meanwhile, SHE went to the store (the very same afternoon with a friend), and she got some AAA batteries. She insisted that they did not solve her problem. AND... she told me a few days later, "Now neither one of those remotes is working. That new one worked for about 3 days, and now it's not working either!" So my wonderful husband went over to check out the remote situation. He said he knew in reason what she had done to cause the new remote control not to work - she had accidentally punched the VCR or Satellite buttons and it was no longer in "TV mode." Sure enough, this is what had happened, but the batteries did not do the trick in the bedroom, so she needed a new universal remote control for that room. My husband got her one and programmed it, and he explained again about punching the TV button if ever the remote controls didn't work. We figure she won't remember that if it happens again, but at least we will know the solution when she calls us.

So, when my cousin sent this video, I had to laugh. Not only did it come on the heels of this experience, but it also ties in with how much complex red tape there is to changing to a new Medicare Part D prescription drug provider (which was my task for today). It also speaks to the never-ending barrage of commercials that now crowd our airwaves about the ensuing switch to DTV. A friend of ours commented just recently that he had just about HAD IT with those commercials and how rampant they are! I sent him this video... he loved it!

I hope you don't think it rude of me to share this video here, and that you realize I share it in the hopes we can all find a little levity in these situations. Having said that... here goes!
video

Friday, November 14, 2008

If It's November, It Must Be Time for New "Part D" Coverage!


Okay boys and girls, say it with me now... "Let's go, Aetna!" You know if it is almost November 15th, it must be time to choose a new Medicare Part D provider! For the fourth time in three years (counting Year One, when someone switched us to another provider without our knowledge and we had to switch back!) we are moving to another insurance provider for my grandmother's prescription drugs. It seems that Humana, who was our provider in 2008 - and who had amazing customer service - is no longer an affordable fit.

In 2008, Humana gave Mam-ma "lifetime authorization" for coverage of a drug known as Aciphex, which controls acid reflux. Her previous provider, CignaRx had required we try other alternatives - other prescription options and OTC Prilosec. None of these worked, and Mam-ma's doctor faxed all of the appropriate documentation to acquire a waiver for CignaRx to cover Aciphex, which is between $150-170 for 30 tablets. In 2008, this came up with Humana, and all I had to to was to tell them that we had been down this road the previous year... I don't believe the doctor had to fax over anything, but maybe. At any rate, they verbally gave me the "lifetime authorization."

The 2009 formulary for Humana does not list Aciphex. Additionally, there will be a $10.60/month premium assessed on even those on total government assistance (Medicare and Medicaid). If a person can't pay this premium, Medicare picks a new plan for you. The last time Medicare picked a new plan (remember, without our knowledge?) it did not cover at least 3 of the drugs my grandmother takes! So I am not going down THAT road for sure! So...I decided if all we would be out was an additional $127.20 per year, that was worth not having to go through hoops to change providers. But just to be sure, I called Humana. Four Customer Service reps, the Medicare rep and 2 days later, I had three people telling me that there would be a monthly premium, two said there would not, NONE of them knew about the $295 "Pre-Initial Coverage Period" fee, and all of the Humana reps said there was indeed a "lifetime authorization" for Aciphex.

What all but the last Humana rep failed to tell me is that for Humana, "lifetime authorization" means until the end of the calendar year. Then all bets are off and you have to appeal/re-apply. My Medicare rep told me from the start that "Aetna looks like your best bet." In the end, she was right... and I called her to tell her so and to clue her in on how Humana views "lifetime authorization."

So, tomorrow is the first day I can make the move... and I will probably wait until next week. My head is spinning from all of these calls and menus and back and forth. I now know the weather in New York, North Carolina, and Dallas! I've been directed to http://www.medicare.gov/ more times than I can count - and I already have an account there with my grandmother's drug info safely stored for quick retrieval, which surprised most of the reps. This is not my first rodeo!

Sadly, though, this maze of confusion will cause countless elderly people who have no advocate to throw up their hands, pay the extra - or worse yet, let Medicare decide for them what plan they get - and they will have no choice. I explained to the Medicare rep this morning that she and her predecessor (who had the good sense to retire and keep what was left of her sanity) are dealing with a generation who may know how to send an e-mail or read something on a website, but for many of them, choosing a prescription drug insurer online is far beyond their scope of computer expertise. Many have never even seen a computer. Unless they have someone to do this for them, they are out in left field.

I also learned from my Medicare rep that I can expect to change plans every year - as the formularies change. She said Medicare regulates some things, but not all, and the private companies can regulate prices and what is covered, and how much, to a large degree. I told her I doubted the average American knew this. I certainly didn't! I was hoping that I had found a company we could settle in with for the long haul, and Humana would take care of my grandmother for the rest of her days. Not so! As long as we have this Medicare Part D program, we can look forward to spending the weeks before Thanksgiving studying formularies, reviewing and comparing plans on http://www.medicare.gov/ and trying to wade through the maze of confusion to figure out which plan is the best and most affordable for the coming year!

I don't mind doing this for my grandmother. I really don't! But it boggles my mind to think about all of the people "out there" who have nobody to do this sort of thing for them. They have no advocate to file the papers to continue their monthly food stamp allotment, their annual assistance with utility bills, their application for Home Health care and whatever else the Department of Human Services feels needs to be added to their file cabinets. They have no one to go to the pharmacy, the utility company, and the bank and secure copies of their statements to prove to the government agencies that THEY HAVE NO MONEY! Since my grandmother's only income is her monthly Social Security check, and the government seems to know everything else about all of us, you would think they already know how much she has and what she can or cannot afford! It would also stand to reason that if she could not pay for Aciphex on December 31, 2008, she still would be unable to afford it on January 1, 2009. That should not require another round of papers from a family physician - especially for the same insurance provider!

So Happy November! I hope you have received your formularies and are carefully examining all of the fine print. I also hope you only have to speak to three representatives or less to get definitive answers. May your phone menus be short and get you to the right person on the first try!

Wednesday, November 5, 2008

Celebrating a Birthday

Today was my grandmother's 96th birthday. We celebrated by taking her to lunch. My sister and her husband and daughter joined Mam-ma and me for lunch at our hospital cafeteria. (My husband was unable to be there because he has taken his mother to visit HER relatives in Iowa.) A friend who was dining in the cafeteria laughed that we had brought our elderly grandmother to the hospital on her birthday... but the food is some of the best in town, and the view of the surrounding mountains and valleys is spectacular. Not only that, she saw several people she knew, and that was a bonus for her! In all, it was a good day, and a time we will treasure. Who knows how many more birthdays we will get to celebrate with her - especially years that she will be this well!














When I took my grandmother home, there was a packet from her Medicare Part D pharmacy provider informing us of changes for 2009. Bottom line... 2 of her meds will not be covered, AND there will now be a monthly premium plus increases in the insurer's co-pay. So, it looks like for the third year in a row, I will be shopping for a new Medicare Part D provider. I've scouted a couple that are options... but both are going to cost us some $$ - more than we have been paying - and I can't sign up until November 15th, so I have a few more days to research things. It looks like I can save as much as $2000 or more over retaining the plan we have presently, so that is certainly worth the hassle factor!

Tuesday, October 28, 2008

You Can Only Control So Much...

It has been awhile since my last post. I got some sort of "bug" the first week of October, and it kicked my butt for the next 10 days, and I've been pedaling fast since then to recover. The challenge for caregivers is to stay healthy - when we are down, who dispenses the care? Thankfully, I have a wonderful husband who is willing and able to pinch hit for me when needed. I prevailed upon him to make the pharmacy run and deliver some blank checks to my grandmother's house on "errand/beauty shop day," and by the grace of God, my niece had a day off and was able to do the actual errand run. My husband could have done it, but I knew my grandmother's medicine needed to be dispensed into her daily dosepacks, and he'd never done that before - my niece is a CNA and was familiar with my grandmother's meds, so she was the logical candidate.

There was no way I wanted to expose my grandmother to my illness - I sounded like a man when I talked, so she KNEW I was sick! And thankfully I was only potentially contagious for a few days, so I missed just one week of errands. But it is a dilemma. What does one do when unable to handle the normal caregiving duties? I think it behooves all of us to come up with a "Plan B." For me, I often have family members I can ask to help. However, I am re-evaluating that plan and considering other possibilities. In my situation, the kicker was the medicine, and I realize now I could have asked for my grandmother's Home Health service to send a nurse to do it (I don't know if an aide would be legally allowed to handle the medication). There were neighbors and friends I could have asked to do the other errands, had no family members been available.

Last week my grandmother told me that she thought she was "coming down with a cold." She said she had a headache and a runny nose. I feared she was indeed getting my "bug." I spoke with her around noon one day, and she felt certain she was getting sick, and she said she would rest that afternoon. The same afternoon, around 5:00, my phone rang. It was my grandmother wanting to know what I was doing. I told her I was scrubbing my shower. She said, "Well, I have the biggest mess of greens you ever saw, and I wondered if you wanted to come get some." I told her that I did not, and I asked where she got greens. She said, "Well, I mentioned to someone at church yesterday that I would love to have some greens, and they went and picked a mess today and brought them to my friend Ruby." She added that her friend had washed them three times and gotten them all good and clean and then brought them over to my grandmother, who had stemmed them and gotten them ready to cook. I asked, "I thought you were sick - do you feel like fooling with greens?" She replied "No, but what else can I do?" I told her she could let them go. She said, "Why, I can't do that!" I suggested... "Who would know?" She retorted, "Well, I would!" I told her if she was too sick to fiddle with them, that was what she should do. She did NOT like that comment!

So I told her to leave a bag of greens in the refrigerator for me, and I would get them later in the week. She agreed. Two days later, I phoned her to see how she felt, and she was much better, and the greens were cooked and in the freezer. I asked if she left a bag in the refrigerator for me, and she said she did. She mentioned how she had seasoned her greens with salt pork, and I said, "I will probably cook mine with bacon." She said, "Well why would you want to do that?" I told her that I was allergic to something in salt pork and could not eat it. She said, "Well, I've already COOKED your greens!" I was not all that surprised, but no less aggravated. I told her that I had wanted them left uncooked because I couldn't eat salt pork. She said, "Well, I didn't put in enough to hurt her." I tried to explain that ANY amount was too much for my allergies, but I could tell that just made her mad. So I told her not to worry - that my husband would eat them. She said, "I just cooked ALL of the greens. I'll freeze these and get you some more." I told her NOT to do that - that I really didn't want/need greens right now, and she certainly didn't need any more! So, when I went for errand day, my cooked greens were still in the refrigerator, and she spooned them up to send home for my husband. I didn't say a word. Sometimes you just have to let it go.*lol*

The grocery list was much bigger than usual. Company was coming - three cousins from Oklahoma. Now the last time they came, they covered two counties in three days, and Mam-ma was exhausted when they left and subsequently got very sick. It took her weeks - actually a couple of MONTHS - to recover. But she had already baked a pan of brownies, and she informed me they were staying at her house, and there was no arguing. If she gets sick, so be it. I couldn't tell her that she couldn't host the company! But I did ask her to promise she would not overdo it and let them wear her out. She assured me if she got tired, she would ask them to take her home. And apparently she did.

My point for this week is that we can only control so much. We are going to get sick from time to time and be "out of the game," and we better have a "Plan B" and a list of "subs" we can call to assist us. And our elders are going to do pretty much what they want most of the time, so we have to learn to accept the things we cannot control. I won't hesitate to speak up if I feel my grandmother is doing something that will cause her trouble later or is too strenuous for her. I am responsible for her safety and general well-being - to a point. But she is always saying that this person or another "is 21," and so is she - in fact she is 96! So I have to let her do what she can as much as possible - and within reason. And just because she cooks the greens doesn't mean I have to eat them!

Tuesday, October 7, 2008

Keep a Close Eye on Things

Last week was not a good one for my grandmother. After a trip to the doctor on Monday for more sample steroid inhalers for her cough and the admonition to continue her nasal spray for the fluid on her eustachian tube, she started a routine of roller-coaster blood pressure. One day it would be 150/80, and the next day it would be 90/70-something. By Thursday when we went to the hairdresser's, she was very week and wobbly, and her BP was about 115/70-something. For probably the last three months, my grandmother's weekly grocery list has changed dramatically. One week, I might buy a cabbage and salt pork - the next, household items and a loaf of bread and some butter. I know she has food in her freezer, so I have not questioned too much - other than, "don't you need milk or eggs?" Almost every week, I buy a package of Chips Ahoy chewy chocolate chip cookies - and at least every two weeks a 6-pack of 20-ounce Cokes and a bag of Hershey's kisses. She tells me that she is trying to keep her energy level up, and those things taste good to her - a woman who almost NEVER ate a store-bought sweet and maybe drank a Coke a month. Now she has a glass of Coke every morning instead of a cup of coffee.

At nearly 96 years of age, I figure whatever my grandmother chooses to eat is HER choice! She has always cooked meals that no other single person I know would cook for just one - chicken, vegetables, mashed potatoes, cornbread - so I wasn't worried. However, lately she has not felt like cooking as much - and we won't even talk about what ensued when Meals on Wheels was mentioned. She does NOT like their menu - and she feels she can't afford it, although I have assured her she can... and even if she only drinks the milk each day, it's worth that. I used to buy her a half-gallon of whole milk AND buttermilk each week - now her milk ruins before she can drink it all.

So, it came as little surprise to me last Saturday morning when her blood sugar was 309! The Home Health nurse reported to my grandmother's doctor (as she is required to do for such a high reading), and he promptly ordered a prescription over the telephone for pills to lower the blood sugar. I felt quite certain that wasn't really necessary, so I told the nurse I was not going to pick up the prescription - that I figured the number was due to Mam-ma's poor diet. Once I explained to the nurse how Mam-ma was eating, she understood fully. I asked Mam-ma to lay off the sweets Saturday and eat a decent diet, and Sunday the blood sugar was 121. Monday it was 110!

Monday morning, the doctor's nurse called at 8:15 and said, "Don't pick up that prescription just yet." I told her I had no intention of picking it up - that Mam-ma doesn't need it, and I told her why - and she talked to the doctor, and now they are going to check Mam-ma's blood sugar 2 times a day for a week and see how it is. She will not be happy, and I don't blame her, but thankfully it is just a finger prick and not full-blown bloodwork.

Bottom line: You have to know the whole story - you have to have the whole picture. It frustrates me to no end that a doctor prescribes a pill over the phone - on the weekend, no less - without having someone's records in front of them, much less all of the facts. With the enormous case load doctors have these days, there is no way they can possibly recall everything about an individual patient from memory and prescribe properly from their living room chair or kitchen table. I would never want to deny my grandmother treatment or in any way interfere with her health and well-being, but at this point, I feel like she and I know more about how she is doing than anyone else. So my suggestion to anyone who is caring for a senior - or someone of ANY age, for that matter - is to consider the WHOLE picture... make sure what you are being told makes sense in the scheme of EVERYTHING.

Be a good detective, ask LOTS of questions, and take a step back and look at all factors before accepting a diagnosis and/or prescription. My grandmother did NOT need a pill to lower her blood sugar - she needed a good plate of meat and potatoes (which she ate!) and an egg or two. The day before her high reading she had capped off the night with a bowl of potato soup and a slice of lemon cheesecake! Thankfully, when the nurse mentioned a pill to her, she had the mental faculties to tell her, "I want you to talk to Debbie first." Your loved one may not be able to do that, so you will have to be ready to step in yourself and handle these situations. Be your loved one's advocate - stand up for yourself - and especially for THEM!

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On another note... for several weeks ago my grandmother has been hinting she might need to go to the hospital. The word "hospital" has been dropped several times, in the context of how well "those girls" (meaning the nurses) cared for her. Last weekend, I reminded her that a trip to the hospital would most likely result in a follow-up visit to the nursing home - if only for rehab. This had NOT occurred to her, and she did NOT like it! She agreed that we do not want this to happen and must do all we can to avoid it. Having to return to the nursing home is one of my grandmother's biggest fears. I told her we do NOT want to go to the hospital - and we certainly do not want to go to the ER. She agreed and said, "I know it is an inconvenience, but if I have to go to the ER, I would rather go to Searcy (30 miles away)." I swallowed hard and said, "I'm sorry, but you do not have a doctor in Searcy except for your cardiologist, and if it isn't related to your heart, he can't and won't treat you. So that is just not an option." I followed up by adding that we have no intentions of going to ANY emergency room, so we were not even going to discuss this. She agreed.

I've quit saying that I've heard it all. There are more wacky comments and ideas to follow... I just know it!

Thursday, September 18, 2008

Doctor, Doctor!

My grandmother hasn't felt well in weeks - she keeps complaining of a persistent cough. To those around her, the cough doesn't seem that bad, but she insists it is "making me week as a hoot owl" and dragging her down, and I can see that SOMETHING is indeed wearing on her. So I guess it IS the cough. I took her to the doctor a week ago, and he gave her samples of an inhaler for the cough and Nasonex for inflammation in her ears - she really does have something going on there - she can barely hear.

Yesterday was our day to drive to Searcy (30 miles from home) to the cardiologist for a 6-month checkup. I grabbed my purse and phone yesterday morning to head to Mam-ma's, and there was a message on my cell phone. I listened, and it was Dr. B's nurse (family physician), Tammy, asking me to call her. I did, and she started telling me about Mam-ma's blood work from last Thursday and how Dr. B wanted her to take B12. I questioned her, and I could tell she did not like having her whole spiel interrupted, but I said anyway, "Wait a minute... she already gets a B12 shot every 2 weeks." "She does?" Tammy asked... "well, he wants her to continue that. And... he wants her to take folate." I asked what that was, and she said, "It's just folate," again acting irritated that I had interrupted her. I didn't care. "Where do you get this folate?" "At Wal-Mart." "How much does she take?" "Just one per day." "What strength?" "It's just folate... it doesn't have a strength. AND... Dr. B wants her to cut her Lasix back to 20 mg morning and noon." I said, "Just a minute... let me find her list and doublecheck what she is taking now." She said, "If you do that, I will have to put you on hold and answer someone else." I told her to go ahead because we had to get this straight.


Soon enough, she was on the phone again. Mam-ma takes 40 mg in the morning and 20 at noon. The nurse said she was now to take 20 in the morning and 20 at noon. I told her we were on our way to Dr. C's for a checkup, and I would run this all by him. I picked up Mam-ma, and she was all decked out in a peach pantsuit... pants, blouse and cardigan sweater all in peach. Mom bought it for her, and peach is a good color for HER, but not Polly... peach is such a terrible color for her (totally drains the color from her skin), but everyone went on and on today about how beautiful she was in her peach... and of course, she ate that up! She got in the car and said, "I really would rather stay home today!" She had two coughing spells - one getting in the car, and another just before we got to Dixie Cafe. (Since our appointment was for 12:15, and sometimes we can be there a long time, I figured we should eat first, so she wouldn't fade on me!) Mam-ma really "puts on the dog" for Dr. C, so today, we took the fancy PURPLE walker, and after lunch, we had to stop at the bathroom - for her to use the bathroom, wash her hands, AND put on lipstick!*lol*

Anyway, just as we got into Searcy, my cell phone rang, and it was Dr. B's nurse again... she said, "You know, when you asked about the dosage on that folate, that made me wonder, and I went back and looked on her chart again, and I told you wrong. Dr. B doesn't want to add those things - he wants to CHECK them... so we need her to come in for blood work." I told her we were just there last Thursday for blood work, and she said, "I know - that's how he found this and wants to check it. You can just drop by any time tomorrow." I told her it didn't make any sense to me that Dr. B was the one who ORDERED the B12 shots, and now he didn't know she was already TAKING it. She said, "HE knows... I didn't." Again, I told her I would run this all by Dr. C.

Mam-ma was furious... she said, "That makes me so damn mad! Why in the s#!t do they want me to cut down on my lasix when sometimes I can't even pee as it is?" Then she laughed and apologized for being ugly!*lol* But I didn't blame her - drawing blood is hard on her, and I told her not to worry - we would see what Dr. C had to say, but we were NOT having blood drawn two days in a row. I asked the nurse WHY Dr. B was doing this, and she said Mam-ma's creatinine level was a little high.

So, when we got to Dr. C's, I told the receptionist I needed to talk to the nurse before labs were done. They let me come back and talk to the lab nurse, and she said she thought they could justify checking the creatinine and such in their blood work there. Then I explained this all again to the nurse practitioner who interviewed/evaluated Mam-ma - and again to Dr. C. Of course, when he came in, he asked Mam-ma how she had been, and she smiled and shrugged her shoulders and said, "I'm fine!" I wanted to scream! Anyway, I was shaking my head "no" behind her, and she started trying to tell him about her coughing spell and seeing Dr. B in July, and she couldn't think of what she wanted to say, so she nudged me and said, "you tell him." So I did. Really, Dr. C did not address the cough or the not being able to hear; however, he said they would have the blood work back, possibly as early as today, and not to do a thing until he looked at it. He was not in favor of reducing the Lasix, and I was glad.

Mam-ma asked him if he knew about her being in the hospital... and I asked when we were there to see him last - March. So I told him about Easter Sunday and the ER and the high BP, and he made notes, and I told him about the royal mixup on the medicine... we have verified with his office that we are on the same page there now... and I told him about Dr. B ordering the Zithromax dose pack over the phone and Dr. C's nurse suggesting we wait and see if the stomach virus didn't subside on its own (which is what we did) and how Dr. C was not a big fan of the Klonipin that the ER doc prescribed, and Dr. C shook his head no and said... "that is a BAD drug." I told him we did not take that, either, and he was glad. And I added that in fact, Mam-ma was allergic to the Zithromax and should never have even been prescribed it to start with. He just shook his head.

So... he said, "let's just tie a big knot in this rope and hang on. You are doing fine, and your heart is doing great, and I want to keep it that way, so I don't want to change a thing. If I see anything different in the blood work, I will let you know. Otherwise, come back in 6 months, and if you need US in the meantime, don't hesitate to call." Then he walked us out and gave Mam-ma a huge hug, which made her day. I did tell him that even SHE will admit that in the last six months, we can't really put our finger on it, but she has lost some ground... but then she will be 96 in a few weeks. He just nodded his head in agreement. I think it just is what it is. He said a little rise in the creatinine level was no big deal... and that she needs her Lasix... she has not had any swelling in the ankles, etc., in the last 6 months, and that's a good thing. I just do not know what to think about Dr. B.


So Greg and I have discussed it, and I am not even calling Dr. B's office back to tell them we aren't coming. Let them wonder. They won't! I told Dr. C that I had learned that I really have to watch Dr. B and some others and question everything, because I don't feel they are really paying attention to things. I don't think he was real happy to hear all of this. I mean, he has Mam-ma doing sooooo well, and they are just trying to screw things up, it seems. Maybe not, but it seems that way.

So, going and coming, as we passed Kroger, Mam-ma wanted to stop and get Tetley Tea. She LOVES Tetley Tea. She talked about it a lot... she wanted one box for her and one for her friend Ruby - Family Size! I told her that Kroger was on our way as we left, and we would stop. I asked, "So you want two boxes?" She thought a minute and said, "Well I tell you what... just get us each two boxes!" So, nearly $10 later and 4 boxes of Tetley Tea - Family Size - we were ready to roll. Mam-ma said, "I need to give Ruby some money for gas... I'll just give her that tea and say 'there's your gas'." I told her to give Ruby some MONEY, too! She tried to give ME $20 for gas for today, and I told her to give it to Ruby, and she said, "Well, she's a workin' for Gladys today so she will get $50." I told her, "that's good... she can have an extra $20... she takes you lots of places, and she deserves it!"

Good thing we ate lunch first - our appointment was 12:15, and we were 1:15 seeing Dr. C... and out of the office by 1:30!!! Mam-ma would have been weak as a dishrag by then. As it was, she was good and tired and ready to get home.

So today is beauty shop and grocery store, and Friday is "chicken foot" (domino game) at noon at Ruby's. Three cousins from Oklahoma have been trying to come stay a weekend with Mam-ma... they were here back in the summer... and they drug Mam-ma all over Cleburne/White County, to the dance two nights in a row, a gospel singing, and she even gave up her bed one night to them and slept on her couch so they could stay an extra night! She loved it and had a GREAT time, but she has not been the same since - and at times, she has been flat out sick. Of course, just after that is when she put up two bushels of purple hull peas and a bushel of green beans! The cousins had hoped to come this weekend, but Mam-ma just is not well enough. Mam-ma said she was going to insist they wait and come later. I suggested she have them come near her birthday, which isn't that far away. She thought that sounded good. I'm glad she is willing to tell them not to come now - she has too much else going on, and she is not well enough for company.

Oh, and while the nurse was drawing blood, she told Mam-ma that HER ear had been stopped up lately, and she cured it by putting peroxide and oil in it! Mam-ma is going to try that tonight. That is basically what is in the ear wax removal drops... peroxide in an oily base... so maybe that will help! Now I am to the point that I don't trust anything Dr. B has said or done... and Mam-ma insists her inhaler and Nasonex are not working, so maybe her ears just need a good cleaning! I hope this cough clears up soon... she has probably irritated her throat with those "coughing spells," but I can see when she coughs like that for several minutes how it does make her weak and wear her down. I'm just encouraging cough drops and cough syrup and keeping her throat lubricated.


Basically, the day went well overall. Mam-ma was content and did not complain or fuss at me, and it was a BEAUTIFUL early fall day... and of course, we got her tea! :-) I am hoping all is well today, and that "the knot" holds!

Thursday, September 4, 2008

And They Say KIDS Say the Darndest Things!

If you have read the posts on this blog, you know that I drove 30 miles to take my grandmother for her pacemaker check back in June, only to find that the clinic no longer did pacemaker checks at that clinic on that day - they had forgotten to call us. Since we HAD driven 30 miles on gasoline that was almost $4 a gallon, the staff scrambled and found a tech who was shopping nearby, and she came and performed the check. All was well - or so we thought.

In August, we got a note to come to our local hospital for a pacemaker check. I phoned the clinic and asked why we needed another. The person on the other end of the line said, "Oh, I see she has not had a check since last November, and by law, we are required to do a pacemaker check every six months. We are making it more convenient for you by having you get this done at your local hospital." I replied, "But she DID have a check of her pacemaker - June 13th!" The girl shot back, "Well...... we have no record of that... it wasn't billed. That's amazing." Without thinking, I quipped, "No it's not!"

After some investigation, and an explanation by me of the mixup and not being notified not to drive 30 miles for a non-existing appointment - and how a young pregnant woman appeared to do the test - the woman said, "Oh, yes, I know her!" However, there was no record of our being in the clinic - no tape from the pacemaker, no report in the file, and of course, no billing! So, we were required to go for the check at our local hospital, which was no big deal. We went early and enjoyed a delicious meal in the cafeteria (one of the best eateries in our community, hands down!) and then we settled in the comfortable lobby of our new hospital to wait for our appointment.


As the technicians were checking my grandmother's pacemaker, the lead technician said, "Now, if you ever have any questions, please feel free to call me. You have my number. I travel a lot, so if I am not there, just leave a message and I promise, I will call you back." My grandmother looked up at her and said, "Well, I hope I never need to call you, because I don't like to talk on the telephone!" HELLOOOOOOO! This is the same woman who told me earlier in the summer when a storm knocked out her phone service at the pole that "that was the longest three days of my life!" I just didn't say a word. I am not sure I had a suitable comment for that one!

Kids MAY say the darndest things, but our elders can shoot back a few zingers of their own!

Saturday, August 16, 2008

Same Old Story...

There is not much new to report. My grandmother has been in a whirlwind of activity with her vegetable freezing - peas and green beans (someone in her church brought her more than a bushel of green beans to string/snap, and another brought her figs for jam!) - and also some wormy apples in her neighbor's yard that she insisted on salvaging and freezing what was good. I guess she thinks she will starve this winter without these things. My freezer and my mom's both house the overflow of peas ... we may never need to buy purple hulls again! Now my grandmother most likely ASKED for all of this food, but why do people bring it... and certainly in a "raw" state? I would never take my grandmother anything that wasn't at least READY to cook, if not cooked and ready to eat.

I am seeing a steady decline in my grandmother, but I can't determine what is causing it... she complains of being tired and cold (although it is a zillion degrees outside in the Arkansas Ozarks summer!)... and she has definitely overdone it with too much activity of late. But still, she doesn't seem quite right - and she isn't thinking clearly at times - worse now than usual.

Last Saturday my cousin married, and my grandmother was considered a "grandmother of the bride" - although technically, she is only related by marriage to my grandfather. However, she looked like a million bucks in her carnation pink dress and jacket, vintage rhinestone earrings and matching beaded bag. She was given a corsage and escorted down the aisle to sit behind the bride's parents and treated like royalty. When I get photos, I will post some. She truly did look beautiful. And after the reception, she had my mother drop her off at a home downtown to visit a family reunion! I have no clue what time those folks finally took her home, so it's no wonder she is tired!

I am noticing more and more elderly men and women and observing how they handle daily living, and none seems to be trying to "conquer the world" like my grandmother. They pace themselves, get Meals on Wheels instead of cooking, and REST when weary. Today I am attending the 90th birthday party of my great-aunt Zula, a retired school teacher. Aunt Zula still lives alone, with a little bit of Home Health assistance and the help of a neighbor and her children and grandchildren. But she gave up cooking and relies on Meals on Wheels, and she is allowing her family and friends to do more and more for her so that she CAN continue to stay at home.

Yesterday, my grandmother's grocery list included salt pork, bologna, and a head of cabbage. I have no doubt she intends to fry the salt pork and cabbage, and I try not to think about the crackling grease that might spew and burn her tissue-paper-like skin. I also try not to envision her blanching peas and green beans in boiling water - or stirring the HEAVY saucepan of scalding candy for peanut brittle. My grandmother's biggest fear is having to return to the nursing home. Now if we can only convince her that in order to stay at home, she will have to chill out a little and let others do some things for her - and give up a few of the activities she so treasures, like cooking! Ah... if only it were that easy!

Tuesday, July 29, 2008

Summer Fun and Garden Veggies

It has been almost a week since we visited the doctor and determined that my grandmother had something that is "going around." The doctor wrote her a prescription for an antibiotic, and she growled. She said, "I wanted you to give me a shot and clear this mess up!" He said, "I'm going to do that, too!" So, she got a Kenalog shot and a prescription for Amoxil three times per day for 10 days! The doctor told her that these, along with an OTC cough syrup, would help, but she would cough for about 2-3 weeks when she talks or laughs. As he left the exam room, she grumbled, "Well, I sure didn't want to cough for 6 weeks." (Where did THAT come from?!) I told her he said 2-3 weeks, not six, and maybe it would be sooner.

So, she is still coughing, but not as much, and I can tell she IS better... although she told me yesterday her aide had told her she needed to see a doctor! I have my doubts that the aide said that... and she doesn't need to see a doctor now... she is BETTER!

Nobody loves a summer garden better than my grandmother. She is now telling people she is "nearly 96" - have you noticed that at some point people quit hiding their age and actually start to brag about it again?! Anyway, she has a little patch of garden in her back yard that a couple of people are "helping" her with - green beans, tomatoes, cucumbers, okra, and maybe a bell pepper or two. She talks about hoeing and watering the beans, and honestly, I have only seen them through a window, but they look beautiful. If ever anyone had a green thumb, it is my Mam-ma!


Last week, Mam-ma told me she was wanting some purple hull peas, and so far, she had not been able to locate any. There is a deacon in her church who has supplied her from his garden for years, but this year he didn't grow any. Did I mention he is about 86 or 87?! She asked me to watch the farmer's market and produce stands for purple hull peas. I stopped at my regular produce stand and bought her a sandwich-sized zip-loc bag of shelled peas - $3.50. She was tickled. She said she would "like to have a bushel if I could get them." I asked if that was shelled or unshelled, and she said "I could sit her and shell them." She said last year a bushel unshelled was about $20. So, I stopped again at the produce stand, and the man told me that he could have a bushel for me on Monday (this was Saturday). A bushel unshelled was $22 - shelled for $30, and he said you actually got more peas - 10 to 12 lbs. So I phoned my grandmother, and she said "Let's just buy the little bags." I pointed out they were much more expensive that way, and we were talking $8 between shelled and unshelled, so she said, "Okay, order a bushel shelled for $30." I did, and I assured the man I would be back on Monday to get the peas.

Yesterday morning, my grandmother called me... "have you gotten the peas yet?" Noooo... I told the man I would come in the afternoon. She laughed and said, "Well, my neighbor just brought me a half bushel to shell!" I told her I was sorry, but there was no way to cancel this order, so she would now have another bushel of peas. She said that would be okay, she guessed, and while she was freezing the ones she was shelling, she could freeze the others, too. To freeze peas, you have to gently boil them on the stove, then drain the water and plunge them into icy cold water - it's called "blanching" and kills any critters and bacteria before freezing. It's hot work... and hard work if you are 96, but she insisted on doing this! So, I took her the peas - a Wal-Mart style plastic bag FULL of peas... well more than she would have netted shelling her own.


As my mom points out... you can buy peas at the store - in a can or a freezer bag! My grandmother cooks about half of one of those sandwich bags of peas at a time, so at that rate, we will have peas for the rest of our lives! At least it has occupied her time for a few days... although any time she is using her stove like that, I cringe and pray she turns off all the burners completely when she is finished. So, if you need purple hull peas, you know who to call!

Wednesday, July 23, 2008

The "Lull" is Over!

Last Friday, my grandmother's cousins came to visit from Sallisaw, Oklahoma. There were 5 in all - four women and one husband. These are wonderful, sweet people who love my grandmother - her first cousin was their mother, and now that she is gone, they have sort of "adopted" my Mam-ma as their substitute mom. Two years ago, they even drove from Sallisaw (a 4+-hour trip one way) to get Mam-ma for their July 4th weekend, then drove her home. So, when they called a few weeks ago and said they were coming on Friday, Mam-ma was excited. She had me buy a pork roast at the grocery store, and she put it in the crock pot on Friday to cook all day for sandwiches. She made potato salad and cooked green beans. Her friend Ruby made a "coconut" cake for their dessert.

The cousins arrived around 7:00 p.m., and Mam-ma served dinner. Then they all loaded into the car and drove to the local dance hall, where my grandmother is a charter member, for some dancing! The next morning, they drove some 30+ miles to visit an old family home place and the adjoining cemetery. They also went to a farmer's market and who knows where else. That evening, they attended a local Gospel Singing event in our city park, and then they closed the dance hall!!! The cousins had planned to leave Saturday evening, but they were too tired, and at my grandmother's insistence, they all stayed with her. She even let the husband/wife have her bed, and she slept on the couch. To my mother's surprise, she attended church Sunday - both morning and evening, I think. I know she went that night.

So, it was no surprise to me that Monday when I telephoned her, she sounded like a man. Her voice was very hoarse, and no doubt, she was exhausted. She had told my mother as much earlier in the day. However, she told me she and her neighbor had taken their walk that morning about 6:30. Then her Home Health aide came and gave her a bath, and then her housekeeper came. She had watered her beans in the garden and filled the bird bath with water (she claimed "the birds were just a pantin'!), and she had peeled Granny Smith apples and put them in the freezer! Did I mention she will be 96 in November?

Today, I phoned my grandmother around noon to see what she would need tomorrow when we run errands and she gets her hair fixed. She said she was lying around and would call me back. She sounded fairly well. At 2:00 p.m., she phoned me, sounding once again like a man, and she started coughing into the phone and telling me she thought she might have to go to the doctor, "if this doesn't get better." I asked, "are you saying you want to go to the doctor tomorrow?" Well, she didn't know... cough, cough, cough. I asked what her aides had said about her, and she said, "Shelley said I needed to see the doctor!" I asked if she would feel like getting her hair done tomorrow, and she said, "Oh, yes... I've GOT to have that done!" So I told her I would call the doctor and see if I could get an appointment for tomorrow. She was coughing hard as we hung up.

The doctor is closed on Wednesday afternoons, so I didn't reach anyone. I phoned my grandmother, and after about 20 rings, she answered. I told her that there was nobody at the doctor's office this afternoon, and she said, "Well, I don't know if I ought to wait!" I was thinking, "great... she wants to go to the ER... I am NOT going to the ER for this!" I asked, "What are you saying?" She said, "Well, I don't want this to turn into pneumonia. I really think I need to go to the doctor." I had told her I would try again tomorrow morning to get her an appointment. I asked, "So you DO want an appointment tomorrow?" She said, "Well, Shelley said I should go, and your momma said I should go see the doctor." I asked when she had talked to Mom about this, and she said, "Well your momma called this morning, and she said 'You sound terrible,' and I told her 'Well, I FEEL terrible!' and she said, 'well, you need to go to the doctor!'" So I told her I would call the doctor on Thursday morning, and if there were no appointments, we might have to miss the beauty shop to get her in that afternoon. She said that was okay.

I phoned my mom, and she was astounded. She said she had called my grandmother around noon, and she was doing great... that she was feeling better! Mom said, "She has never coughed once while talking to me!" But, she agreed that it is best to take her to the doctor if she wants to go and cut my losses... and make sure there is no pneumonia. She said she did NOT mention a doctor to Mam-ma, and Mam-ma did NOT tell her she was terrible. So, I am left to wonder if this nasty coughing into the phone is for my benefit - and effect - or if she is genuinely having trouble. She told Mom she "got this Sunday night." We have a high mold count right now, so I am wondering if that is the culprit. Mom was pretty sure Mam-ma said she walked with her neighbor this morning!

So we will never know the truth, but it looks like "errand day" will include a doctor visit! I'll let you know how it goes.

Meanwhile, a friend of mine is dealing with the admission of her aunt to a nursing facility in Missouri this past weekend. The woman has been diagnosed with Alzheimers but was "covering well" until recently, when her sister visited for a month, and afterward she told a family member, "Some strange lady came and stayed a whole month in my house - wasn't that brazen of her?" The family realized that this lady could no longer live alone. She didn't go peacefully to the facility - in fact, a seatbelt is all that prevented her from trying to escape the car... she threw open the door but was strapped in and couldn't get free. Alzheimers is a truly ugly disease... and so heartbreaking.

So I guess when I consider what others are dealing with, I can handle a little nonsense from my grandmother who still seems to have most of her faculties on any given day!

Hang in there - keep pedaling!!!

Thursday, July 17, 2008

The Savages

If you haven't seen the movie, The Savages, you might want to give it a look. I'll tell you now, it's quirky... and a bit over the top and "adult" in spots, but it deals with the issue of two siblings placing a parent in the nursing home... and their lives are already complicated. Juggling a personal life and this new responsibility is depicted as a challenge. I found the portrayal of the nursing home personnel to be extremely kind - maybe too generous (I don't recall someone always tucking my grandmothers in each night!) - but at least they were not made out to be cruel or overly unprofessional.

The other movie that touches on this topic is Away From Her, which deals with a woman (Julie Christie) who has Alzheimers - and her choice to go to a nursing facility - and how this decision affects her husband. It is sad and poignant, but a jolt of reality at the same time. It also has some light-hearted moments, and Olympia Dukakis has a starring role, which is always a plus in my book. I'll warn you - my mom didn't like the way it ended... and it did sort of seem to end "unfinished," but it is still worth seeing!
On the home front, things are about the same in my neck of the woods. My grandmother shows signs of decline, such as occasionally forgetting to take her medicine, but she is still gardening and cooking and living alone, attending church on Sunday, playing dominoes and going to shop and visit through the week, so what more can you ask for at 95+ years young?! I'm enjoying the relative "quiet" of this lull in activity, feeling fairly certain it won't last, but grateful for the time I am given. I hope things are going well for you... let me know the latest!

Wednesday, July 2, 2008

Be Sure to Read...


Please take time to read JJ's comments to the post "We're In a Lull" - I think you will relate on some level - and you might just get a chuckle or two along the way!


He also added in a side not to me: "I do sometimes feel like a bologna sandwich. A bologna sandwich does the best it can to make things better and give nourishment, but no one really appreciates it, and I think we have all felt that way.

I like the laughter quips you put in there. A good one I have loved since I first saw it, and you may have already used it but here it is anyway. LOL My mother was told about five years ago to walk at least five miles a day, so she did what the doctor said to do. Now we have no idea where she is."

Debbie

Tuesday, July 1, 2008

We're in a "Lull"!

I hesitate to mention that we are in a "lull" because that usually invites trouble! And... some of our "lull" is because I did something to my back a couple of weeks ago, so I didn't see my grandmother last week - just spoke with her by phone. Luckily, my mom was in town and could run her errands. My grandmother called me every day for about a week to see how I was - and to relay what she needed - "I'm out of cash!" - "Did you pay my tithe?" (wasn't time yet - she forgot, she said!) She had plenty of people to see after her while I was out of commission - Mom and her husband power-washed the outside of her house one day, my cousins helped her with her garden another, and the man came to mow her yard, just to name a few. I am up and going again, so I will see her this week for "Errand Day". It was time last week to refill the daily medicine boxes, and I told Mom how to do it, and Mom said as she sat filling the little boxes, Mam-ma said, "I told Debbie I could do that myself!" Mom said it was a daunting task, as she made sure she got the right things in the right boxes. I agree, and that is why we do that for my grandmother!

There WAS one thing the last time I did errands. I picked up my grandmother for her appointments, and she was not ready for me, which was unusual. Usually she is tapping her toes at the door. I entered her house, and she walked past me and out the door. I asked, "Where are you going?" She replied, "I don't know." I reminded her she didn't have her purse or the remote for her garage door - two things she always takes with her. She came back into the house to get her things. I noticed on the kitchen table that Mam-ma's little pill cutter was out of the box. "Why is the pill cutter there?" I asked. She spun around and said, "Well, you didn't leave me any medicine for today." I looked at her and asked, "so you cut a pill to take for today?" "No," she answered. "There wasn't anything in the box for noon Thursday, so I didn't take any." I asked why she didn't look in the OTHER set of boxes for Thursday, and she said, "Well, you didn't leave me any medicine, so I figured you didn't aim for me to take any today." I asked if she had taken her morning meds - yes, they were in the box.

I remembered that the last week, when I filled her daily boxes (on a Thursday afternoon), I deliberately did not put any medicine in the Thursday morning and noon compartments of one set, so that my grandmother would not become confused (I hoped) and take a double dose, thinking she forgot earlier. BUT... she didn't understand that, so from now on, I will just lay out the evening medication for that day on her kitchen table and fill ALL of the compartments. Lesson learned on my part - and as my husband pointed out, she may have not taken the medication for my benefit - but we DID stop long enough for her to take her noon meds before we left for the beauty shop! Mom said some of a Friday set were missing when she refilled, and Mam-ma insisted it was "right," but Mom isn't sure. So, I still don't know for sure that Mam-ma takes her meds right, but she seems to be doing fairly well, so we will hope so.


My sister-in-law is having all manner of challenges with her parents. Her mom is 90 and her dad is 89. I think I related in an earlier post that severe storms caused a lot of damage to these folks' home and business back in the spring, and my sister-in-law and brother-in-law have made several trips - about 3.5 hours one way - to clean up the yard, and meet with insurance adjusters and repair people. Mother's Day weekend, my sister-in-law's mother had some sort of accident as she turned outside and started to go into the house. She fell and broke three ribs, pulled muscles in her shoulder, and was really banged up pretty good. She is convinced she had a mini-stroke.

However, some months ago, this lady dropped a plate on her foot, and my sister-in-law thinks she suffered some nerve damage, and from time to time the foot feels "heavy" and sort of "goes out" on her. There have been tests and doctor visits, and the consensus among medical personnel was that there was nerve damage to this foot that caused the fall. An MRI was talked about, but at the time, the pain and discomfort from the broken ribs was such that this lady could not lie still for an hour in the machine. She has steadily improved from the broken ribs and is getting around better now... all things considered - she has macular degeneration and only has limited peripheral vision, so her husband has to help her navigate (and he doesn't hear well, but that's another story!) - and she has even started to get out for Garden Club coffee, and things like that.

My sister-in-law (an only child) and her husband traveled to visit her parents this past weekend and handle some things with the insurance people. She e-mailed this report afterward: "My mom called to tell me she had another spell yesterday when she went with my Dad to check on the store. This time her left leg got heavy and so did her right, and her knees started to buckle. She held on and did not fall. So she had a dr. appt. today and she is now scheduled for an open air MRI on Wed of the lower back, & they are making an appt with a neurologist & want her to do PT at Health South. I don't think she needs to do PT until they find out what is wrong. She does not want me to come up there for the MRI so that is good. She is much more ok with that now. Also my Dad gets some free tests done with his 55 Plus club & his hemoglobin came back VERY low - it is 9 & should be 14, so he is going to the dr. tomorrow at 4. It just does not seem to let up." Do you relate? These dear folks still live alone in their own home, and they have no intention of doing otherwise. We all see the handwriting on the wall, but my sister-in-law and brother-in-law seem to be taking it one day at a time and just holding out as long as they can. They realize the day is quickly approaching when they will have to step in and force the issue... most likely when something major happens to one or the other that means they can no longer live at home.


I am so thankful that, for the moment, my grandmother is still able to live at home alone - and I almost added "safely" but some days I wonder about her and her gas cook stove and those trips out in the back yard to hoe her green beans in her little garden. But we do have a plan in place - we have already done the nursing home gig three separate times for rehab, and if something major happens, that will become a permanent residence, sadly. All things financial were arranged for that long, long ago, and if that fateful day comes, we will be ready. But so many are not... and the toll it takes on the children, aside from their parents' grief and frustration, is immeasurable. I know my sister-in-law and her husband will need a lot of support, and we will be there for them.

I spent an hour at the local nursing home lately giving an overdue piano concert to a friend of mine who is a resident there - she is 100 years young now, and for her birthday, I promised her a recital. She is still very clear in her thinking and relatively healthy, but at 100, she is not able to care for daily needs like meals, bathing, and general mobility - although she does drive a mean wheelchair! The hour was so rewarding... many residents came to hear the music, and then we sang hymns. I learned very quickly that, regardless of one's mental capacity, hymns are a universal common ground. People who could barely hold their heads up and put two words together sprang to life, so to speak, and began mouthing the words, or humming the tunes. If they didn't know the verses, almost all knew the choruses. And the smiles on their faces and the peacefulness in their eyes as they sang familiar songs was priceless. I will be doing that again soon!


I heard lately that at some point, you quit trying to hide how old you are and start bragging about it, and with a 96th birthday only four months away, that is my Mam-ma! While the time spent with the nursing home residents was rewarding, and it was a blessing to be able to bring them a little joy in an otherwise routine day, I also was keenly aware of how fortunate I am that my grandmother is not there. I am blessed that, even with all of her antics, she is still physically able to live alone - and more than that, she is still of fairly sound mind, save a little forgetfulness. She remembers what she told you two minutes ago and doesn't repeat the same thing over and over in rapid succession. She just completed baby blankets for two new twin nieces. She still keeps up with news and politics. ?And.. she still gardens!

Friday, June 13, 2008

Today was a GOOD Day!

Today really WAS a good day. Yesterday, in addition to errands, Mam-ma had an appointment late morning with her local physician... a "3-week follow-up" visit. That went fine - pat on the hand and come back in 3 months - and I dropped her off at home to have lunch and a little rest before going to the beauty shop at 2:00 for a hair permanent. It took longer than expected, and we were nearly 4:30 getting her home, and Mam-ma was worn out and cranky! I told her to rest, because today we had to travel to Searcy (30 miles away) for a pacemaker check at the cardiologist's.

I arrived a little before 9 a.m. to get my grandmother, and we drove to Searcy. Our visit was pleasant, and she looked great in a pair of light blue slacks, a soft peach-colored t-shirt, and a jacket in a checkered plaid of pastel blue/peach/white. She had on nice "gold" jewelry I had given her and her white Keds tennis shoes, and she looked really sharp - certainly not 95 years old!

We arrived early for our appointment, and the receptionist took our information and became flustered. Seems there was a change at the cardiologist's office, and they no longer do pacemaker checks on Fridays, and someone was supposed to contact us, but that didn't happen. I explained we had driven over 30 miles for the appointment, and my grandmother added, "And gas is $4.00 a gallon!" The girl scrambled and called a technician who happened to be nearby. Bottom line: the test was done, and we were actually out of the clinic two minutes after our scheduled 10:15 a.m. appointment! But we will call ahead next time and make sure everything is as it should be!

We went on to shop for fabric. I want to make new draperies for our bedroom, and Mam-ma is a master seamstress. She doesn't sew much any more, but she still knows what she is doing in that department, so I value her advice. She helped me select a great fabric and coordinating lining material, and then she helped me match up just the right shades of thread. Then we went to Wal-Mart! Don't all roads lead to Wal-Mart?!

Mam-ma pushed a cart as I shopped for hardware for hanging the new curtain, and then we picked out a wedding shower card she needed and she bought some candy. And then she treated me to lunch at Dixie Café. It was delicious. On the way home, we stopped at a couple of yard sales. One sale was at a home that had belonged to my great-grandparents - Mam-ma's inlaws - and she enjoyed being back on "the old home place" and visiting with the daughters of the latest owner, who passed away recently. Mam-ma knew these ladies, and they even shared some "forget-me-nots" from a planter in the front yard with her. Mam-ma said it would be a way to remember their mother, Emma.


Mam-ma didn't have many complaints today. She looked well and seemed far younger than 95. She was truly a lot of fun, and it WAS a GOOD day.

Yesterday, while Mam-ma got her permanent, I went to one of the local nursing homes to visit my great-aunt Mary Louise and a dear friend of our family, Mrs. Charlsie Little, who celebrated her 100th birthday earlier this spring. I had promised Mrs. Charlsie a piano recital for her birthday. Her daughter-in-law was my piano teacher until I married, and I knew that Mrs. Charlsie would appreciate a piano recital about as much as anyone. That was probably one of the most rewarding hours I have spent in a long time. I watched Mrs. Charlsie's face as I played... she was engrossed in the music - moving and swaying to the rhythms, and when a hymn was the theme, she sang along. I asked if she would like to hear "Clair de Lune," and she said "YES!" so I played for her. She was lost in the melody and swaying again. Others came to the dining room to enjoy the concert, and one lady would yell when I played, "That's too loud! She plays too loud." When the volume would dip, she would comment, "That's better!"

When I finished playing the songs I had prepared, I decided that maybe a few hymns and a "sing-along" would be fun for them, so I started playing a few. It was amazing. People who had been sitting slumped and lifeless suddenly sat up, sprang to life and began singing! Hymns are a common denominator, and when the mind forgets many other things, it still recalls choruses of old familiar hymns, apparently. We sang and sang!

My great-aunt, who is nearly 87, recognized Mrs. Charlsie as one of her school teachers. She moved closer to her to visit, and she related that a boy in her class had padded his pants with books to avoid the discomfort of a paddling! She couldn't recall his name, and neither could her teacher, but my aunt, who is not nearly as clear-headed as Mrs. Charlsie, repeated this same two thoughts over and over and over - as much as 9 or 12 times! It got really sad and frustrating, but she was totally oblivious. I am quite sure she never did understand who I was, though I explained several times that she was my grandmother's sister - and I was her great-niece. I commented later that I gained a new appreciation for how "with it" my grandmother is still at 95 years of age. Her friend Charlsie, just five years older, cannot see and is unable to live alone and care for herself, and Mary Louise has already "gone around the bend" apparently. I don't know how my Mam-ma will be at 100, if she lives that long, but today it looked like she might still be doing fairly well!

I realize that everything is relative - and precarious. I arrived home to the news that Tim Russert had fallen dead at age 58. But I am grateful for this good day with my grandmother. I know that each one is different - and who knows how tomorrow will be - so I will focus on the GOOD DAY today and be glad for that for now!

Thursday, May 29, 2008

It's Thursday... Again!

Funny how fast Thursdays seem to roll around. Today, my grandmother had lost her "food stamp card." She was very upset about it... looked everywhere - purse, jackets, pants pockets. I know it will turn up, but she doesn't think it will, so she set in to replace it. She called DHS, and someone gave her an 800# to call. She got a menu, which totally frustrated her, so she called ME!

I called the 800# and went through the menu to the desk for lost or stolen cards, and the person who answered, Gloria, asked for the Social Security number. I gave it and my grandmother's name... Willie Dove... and Gloria said, "Willie is your husband?" "No," I replied, "she is my grandmother. I have her durable Power of Attorney." "Well you are not listed on my records," Gloria answered. I've heard this before, but since I have been handling all of my grandmothers business affairs since 2003-2004, it is very frustrating when they tell me I am not listed or authorized. "I can't give you any information, since you are not listed in your grandmother's records." I nicely explained that my grandmother is 95, she has lost her card, and she could not navigate the menu. She is upset to the point that she says she "is sick." Gloria says, "I understand, but unfortunately, I cannot give you any information without your grandmother's authorization." So I asked, "Then how do we resolve this?" Gloria explained that all she needed was an authorization from my grandmother. "Hold on," I told her, "I think I can fix this."

I picked up my cell phone and dialed my Mam-ma. After several rounds of "Mam-ma, Mam-ma" and her saying, "Hello? Hello?" I got her to answer me. "Mam-ma," I told her, "this lady in the Food Stamp office needs to ask you if it is okay for her to talk to me about your card. So I am going to hold the phone to my other phone, and you can answer her questions. I turned up the volume on my cell phone, and I immediately heard my grandmother... "Hello? Hello?" I told her to hold on. Gloria cannot hear her. Mam-ma tells me she is practically yelling! I asked her to listen again, and this time, Gloria attempts to ask a question. The whole time, Mam-ma is talking... "What is it you want to ask me? This is Xxxxxx Xxxxx Xxxxxxxx (giving her full name)." I once again stopped her and told her, within earshot of Gloria on my cordless landline, "Mam-ma... this lady wants to know if you will authorize her to talk to me about your food stamp card." At a volume approaching screaming, Mam-ma says, "ABSOLUTELY!" Gloria starts to laugh and says, "I heard that!" That was all that I needed from my grandmother, so I told her to hang up and I would call her back later.

THEN... believe it or not... Gloria said, "I just need to verify your grandmother's address." I gave it to her, and she says, "Nooooooo... that's not what we have on file." I explained that she has lived at that address since 1988, and Gloria says, "Well, I have an address in Heber Springs, but that's not it. I show a Debbie Robus as the contact." She couldn't see me rolling my eyes, but I told her, "That's ME! You must have my address... XXXX Xxxxxxx Drive." Yes, she says that is what is listed. I explain that my grandmother's address is different (and I do not tell her that I have since moved and no longer live at that address myself). She says she can only deliver the new card to the address on record. Since most of my mail is still forwarded, AND I know the people who live in our old house, I tell her yes, that address will work. She says, "I just need to verify who I am talking to." I had to laugh, as I told her, "Debbie Robus... the person in your records." She says, "Okay... I had to ask." So, a new card is to come in about 7 days, hopefully. The card presently has $26 on it, which I told Gloria just as well be $26,000 to my grandmother, and she replied, "Well, of course!"

Meanwhile, I stopped in to see a friend of mine today at her store, and she was really frustrated. "I don't want to be part of the 'Sandwich Generation'!" she said, looking very frustrated. Her parents need to downsize, but that would mean moving from and/or selling family land - land that has been in her family for generations. Her older siblings are balking. "Don't sell the land!" they cry from several states away. The ultimate care of her parents and their needs has fallen to her, it seems. I told her that, unfair as it is, that's usually how it goes. I tried to be as supportive as I could, but I know her frustration - and there are no easy answers.

On a local morning show this week, a psychologist discussed how disputes over land and property and personal belongings often spell "the beginning of the end" for families. Hurtful things are said and done, and sadly, sometimes the damage is irreparable.

So here's a question for you... how are YOU handling the issue of personal property, downsizing those in your care (parents, grandparents, aunts, uncles, etc.) Are your siblings or other relatives cooperating and being supportive? Is the person in your care cooperating and acting agreeably? Let us hear from you. We can all learn from each other's experiences... share yours and help somebody else!

And finally, I learned today of yet another senior citizen who "didn't think it could happen to them" and now finds themselves the victim of a fall that has resulted in almost spontaneous need for added care, medical attention, and possibly even a move to be nearer to loved ones who can look after them. Preparations? There have been none. What about you? How have you prepared for this day? Have you buried your head in the sand and hoped it doesn't come? Or have you made some arrangements and laid some groundwork so that if/when, heaven forbid, something DOES happen, you are at least somewhat prepared. Share your ideas and thoughts on this issue, as well!

All Together Now - Let's Laugh!

Morris and his wife Esther went to the state fair every year, and every year Morris would say, "Esther, I'd like to ride in that helicopter."

Esther always replied, "I know Morris, but that helicopter ride is fifty dollars, and fifty dollars is fifty dollars." One year Esther and Morris went to the fair, and Morris said, "Esther, I'm 85 years old. If I don't ride that helicopter, I might never get another chance."

To this, Esther replied, "Morris that helicopter ride is fifty dollars, and fifty dollars is fifty dollars."

The pilot overheard the couple and said, "Folks I'll make you a deal. I'll take the both of you for a ride. If you can stay quiet for the entire rideand not say a word, I won't charge you! But if you say one word, it's fifty dollars."

Morris and Esther agreed and up they went. The pilot did all kinds of fancy maneuvers, but not a word was heard. He did his daredevil tricks over and over again, but still not a word.

When they landed, the pilot turned to Morris and said, "By golly,I did everything I could to get you to yell out, but you didn't. I'm impressed!"

Morris replied, "Well, to tell you the truth, I almost said something when Esther fell out, but you know, fifty dollars is fifty dollars!"


Thursday, May 22, 2008

More "Sandwich" People Speak

Carol writes, "Why is it that 'I'm fine' is such an automatic response? I watch my mom and I see the changes. The increase in weakness, the change in her color, the cough and finally comes the difficulty breathing. It's been coming on for the last week. She tells me this morning that it was so hard to breathe during the night. So we're off to the hospital and she's admitted. Chronic heart failure is once again the culprit. Why do we find it so difficult to admit that we feel like crap? Is it our German background that makes my family so stubborn? Should I have forced her to get checked out days ago? She's too heavy to throw over my shoulder.

My dad died 6 hrs before his 80th birthday. My mom turns 82 on Sunday. No matter how much we do, it seems like (for me at least) that we should be doing more. Do you think anyone would notice if I ran away? Thanks for listening.

Here was my reply: Carol... I am sorry that your mother is not well. However, don't be so hard on yourself - or her. Truly, at this age, it's like the little child whose fever spikes... one minute they ARE fine, and the next, they are in full blown CHF or something else. My grandmother attended a birthday party one Saturday afternoon and was "fine". She was "fine" at 7:30 p.m. when she telephoned my sister and cousin. At 9:30 p.m., she was seriously ill with vomiting and diarrhea that landed her in the hospital for 5 days and the nursing home for 2 weeks of rehab... and she is just NOW becoming her "old self." When she was admitted to the hospital that night, her lab work showed she had a UTI, pneumonia, and strep throat, in addition to the virulent diarrhea and vomiting. She had symptoms of NONE of this 3 hours earlier.So yes, some of it is upbringing. Some of it is stubbornness, and some of it is just plain ole aging. At any rate, it isn't any fun, and I'm so sorry this has happened. I wish you well and hope your mother will soon feel better - and you as well!

On another front, my husband's brother John and his wife Elaine traveled almost 4 hours on Mother's Day weekend to visit her parents. As an only child, Elaine is quickly becoming responsible for many things that her parents can no longer address on their own. Her mother recently celebrated her 90th birthday, and I think her dad is getting close to 90 himself. Recent storms and tornadoes caused damage to their yard and the roof of their house (creating leaks in spots), so it fell to Elaine - and John - to see that the repairs were made.

While working in the yard the Friday before Mother's Day, Elaine's mother started inside the house, and something happened and she fell. She broke two ribs and hurt her shoulder - and x-rays this week revealed that she has also broken two bones in the top of her foot just behind her toes. The doctor has bandaged the foot and told her to stay off of it as much as possible - and to use a rolling walker when she DOES go anywhere. This woman also has macular degeneration and can barely see, so she is really disabled. Because she takes the blood thinner Coumadin, the only pain medication prescribed has been some extra strength Tylenol, and she is in a lot of pain.

My sister-in-law is frustrated, of course. She is a leader in a community-wide Bible study group in her city, and she devotes much of her week to work on her lessons, caring for those in her group (and others) and taking care of her family and friends. The Bible study group doesn't meet in the summer, and they just broke for summer break. She told me, "I had so many projects and plans to accomplish this summer, and now it looks like I will spend much of it with my parents." I feel her pain, don't you?! She knows she is not alone, but when this situation first hits you, you feel a little like you have had the breath knocked out of you - and more than a little overwhelmed. I know she will get her "sea legs" and be fine. But if you are just having your world turned upside down by a parent who has become suddenly ill or infirm in some way, know that you are not alone - and that we are here to support you and encourage you as much as possible.