Saturday, December 12, 2009
Timmy is seven months old now and mesmerized by the Christmas lights and decorations. Most years, I have my Christmas shopping done by October, the cards mailed by the first week of December, presents wrapped and under the tree the 2nd week, and baked goods to share with family and friends. This year I have most gifts purchased, cards e-mailed - but a box for mailing on the desk, nothing wrapped, and no baked goods. Hopefully I will have a couple of days in a row where I can knock out a few things on my list!
Medicare Part D enrollment is complete for 2010 - somewhat less painful this year than in those past. Everyone is healthy for the moment. We really are blessed and have little to complain about... although we do seem to find something... but I'm working on that, too!
Cousins came from Oklahoma to visit my grandmother Thanksgiving weekend. They brought her twenty-five gifts... wrapped and numbered. She was instructed to open one gift per day, in the order listed, until Christmas! She is having a ball with this. The first day it was a wreath. Day 2 brought a pretty pin for her coat lapel. Day three it was a box of Christmas cards - AND stamps! Day 4 she got a Christmas coffee mug. And so it goes. This was a genius idea - and took a lot of work and thought. But you might have a senior on YOUR list whose holidays would be brightened by this gift extravaganza!
When I did my grandmother's errands this week, she seemed more confused than usual. I spent extra time at her house helping her with some Christmas cards and things... and just reassuring her that she was tired (probably from making peanut brittle the day before) and this would pass. But I do see a steady decline in her. And while I know she can spin on a dime, for the moment, she seems to have mellowed a bit and is very kind and appreciative - and cooperative. Maybe she is just too tired to argue! At any rate, her little house is cozy and decorated for Christmas, thanks to her housekeeper and friends who have brought in fresh greenery and such. Her gifts are purchased and ready to deliver. She is looking forward to spending time with her family on Christmas Eve - especially her great-great grandson Timothy. And the daily packages have given her a reason to get up each morning.
In some ways, 7-month-old babies are not all that different from 97-year-old great-great grandmothers. They both need lots of love and attention. For the moment, God is giving me plenty of stamina to meet these needs... and I have no doubt He will continue.
Have a blessed, happy 3rd week of December!
Sunday, November 15, 2009
On Friday, November 6th, I picked Mam-ma up for her beauty shop appointment, and the house smelled like a bakery. I knew from posts on Facebook that the children of a cousin who lives in Little Rock had called and wished Mam-ma a "Happy Birthday," and one of them mentioned he liked her sugar cookies. She replied, "Well I'll bake you some, but you'll have to come see me." When I smelled the cookies, I knew she had taken his request quite literally. She began telling me that "the kids are coming," and I cautioned her that "soon" to them probably didn't mean right away. She didn't buy it. So when I got home, I posted a comment on Facebook and let them know that Mam-ma had already made the cookies for their son. They came on Sunday, so they avoided the dog house!
As we left for the beauty shop, Mam-ma said, "My walker needs new tips on the legs." Now I think I posted here a few months ago about the ordeal of getting new legs for her walker when "all I wanted was two tennis balls." So I said, "We've been through this." Well, this was ANOTHER walker, and the tips were shot. I said, "Let's take the walker I had fixed for you a few months ago, and you use this walker outside where the tips don't matter." She said, "Okay, but THIS walker has wobbly wheels." I couldn't see it, but she reluctantly took the newer walker, and I told her that the next Friday, I would factor in time to take it by the medical supply store for a look/see.
Over the weekend, my sister and I were talking, and she said, "I'm worried about Mam-ma... she said she hadn't done well for two days." I asked if Mam-ma told her about the cards, phone calls, visits, cookie baking, laundry she had folded, etc., and she said, "Noooooooooo." That explained her exhaustion!
When I picked up Mam-ma the day after her birthday, there were several pieces of mail for me... the new Aetna formularies for Medicare Part D prescription drug coverage, and two letters from the Arkansas Department of Finance telling me that Mam-ma's handicapped parking sticker is expiring. I read through everything - as expected, Aetna will not cover one of Mam-ma's most expensive medications in 2010, so for the FOURTH year in a row, I am choosing a new provider and making the switch!
One morning I sat down to review the providers and see if I could figure out which insurance company might fit Mam-ma's needs. I went to http://www.medicare.gov/ and began the comparison process. First you have to enter your Medicare ID number, your birth date, the date Medicare coverage began, and a few other things. If for any reason after you advance to the next page you hit the backspace key, you lose every bit of that info and have to retype. I know... I've learned the hard way. Now once I get to the actual page for comparing providers, I have "saved" my grandmother's prescriptions for reference, and I can edit dosages and even add or subtract prescriptions if needed. However, to do this initially, I had to enter each drug individually, along with the dosage and the number of pills she takes per month. It wasn't hard for me, but then, I am not quite a "senior" yet and consider myself fairly computer savvy.
I adjusted Mam-ma's meds and added a new one and removed the old one and SAVED my info again. But before I did this, I realized that the website now offers a "My Medicare" option, where you can create a login and password, and you will be able to retrieve all of your information about Medicare coverage, including what you have spent, what is still available and allowable, and more. So I thought, "Great! If I get a login and password, maybe I won't keep losing my info each time and having to retype things." Here's what happened. I created a login - and there were specific instructions about how to make it something you will remember, but not something others might readily know. Then I gave my e-mail address and I was told that a temporary password would be sent to my e-mail account - and mailed to Mam-ma! (Won't she be tickled?!)
I checked my e-mail account, and here's the good part... to create my temporary password, I had to take the first letter of my grandmother's first name, then add the last four digits of her Social Security number, followed by the first letter of her LAST name, followed by a code that Medicare gave me in the e-mail message. Once I was logged in with this password, I could change it to anything I wanted, as long as it included at least 8 characters, a letter AND a digit, and any number of characters such as *,&, !, and others that are generally not allowable in all things Internet or computer! Now I had to laugh... what genius came up with this procedure for SENIOR CITIZENS?! It truly boggles the mind.
I now have a call pending with the Medicare office in Dallas, as I do each year, to clarify questions for which I cannot find answers on http://www.medicare.gov/. I think I know the answer, but I have to be certain!
So Friday, I picked up my grandmother for her hair appointment, and she practically met me at the door, pillowcases and embroidery thread in hand... what did I think about lavender? I told her it was fine by me. Then I started to dispense her medications into her daily pill boxes. She had not taken her night-time medicine four out of seven nights. She had missed two morning doses, and her Friday noon medication was still there - and it was almost 2:00. I discussed this with her, and she had no clue why she had not taken all of her medicine - and honestly, she didn't realize she HADN'T taken it! She had, however, worried herself silly over a "shoebox" for the church for a project for Franklin Graham's Samaritan's Purse Organization, called "Operation Shoebox." She and her friend Ruby had both stuffed shoeboxes full of toys, candy, toiletries, small workbooks and more, and Ruby had wrapped the boxes in padding and then covered them in colorful Christmas fabric. A couple of 5-9-year-old boys in a foreign country will get a real treat this Christmas!
Mam-ma took her noon-time medicine, and we started to the beauty shop. She showed me the old walker and said, "I just took those tips off... they were shot." I told her that I planned to get her newer walker looked at while she was having her hair done. I took her to the hairdresser's, then drove to the medical supply place. A very nice man and woman looked at the walker and declared that "Someone has put the miles on this!" The wheels were worn flat and hard... and the walker itself was completely out of alignment. They could put new wheels on it, but there was nothing to be done about the alignment. The woman said, "Since Medicare has provided her with a new walker in the last five years, they will not pay for a new one, which is $120. But I have a used one that is refurbished and perfectly good that I can sell you for $50." I told her I would take it. So I got a new walker for Mam-ma to use at church and when she goes places with Ruby, and we agreed she could use the old wobbly one with new wheels outside and in the yard. When I got home, I wrote OUTSIDE in black magic marker across the handle rails of the old one, and I put her name on the new one.
But before we could get home from the errands/beauty shop, we had to stop at the Department of Motor Vehicles and get a photo ID and new handicapped parking sticker. Mam-ma somehow qualifies for two of those hangers to place on the rear view mirror, and she wanted BOTH of them. Just as it was our turn to be served, the computers went down, so we had to wait about 20 minutes. But we got the photo ID and two hanging permits.
Back at home, I started putting away my grandmother's groceries, and she said, "I don't know why I'm so out of it." and I reminded her it was due largely to not taking her medication. She didn't answer me. I insisted she has to try harder to remember to take it and not get so busy. I finished putting away the groceries and dispensing her medicine, then I took probably 10 pieces of clothing off her clothesline - she had hung each one on a hanger and pinned it to the clothesline with TWO clothespins! That line is high - I have no idea how she did that and balanced on a walker! AND... there was a THIRD walker at her back door that I had never seen before! Counting her "good" one inside, she had FOUR walkers! I folded up the one with no tips on the legs and put it in my car... and I told her it was going away!
Here's the kicker... my husband and I went to the local high school football game later that evening, and Mam-ma's Home Health Aide, whom I've known for over a decade, asked, "Did you help Mam-ma get her peanut brittle made?" "What? Peanut brittle?" I had not heard this one. The aide went on to say that when she helped Mam-ma that morning with her bath, she said, "I wish you could stay all day and help me." "With what?" the aide asked. "Making peanut brittle!" my grandmother replied. This makes the second year she has made peanut brittle "on the sly" and tried not to let me know about it, because she thinks I will fuss at her. And I might - she handles scalding molten candy in a HEAVY saucepan, and one winter she required physical therapy on her shoulder after a Christmas season of making peanut brittle. Hers is the best around, and she will probably make close to 50 lbs. of it this year. Last year she made nearly that much and never once asked me to buy as much as a peanut, much less sugar and corn syrup. She had friends and church members keep her in supplies and help with deliveries.
Knowing all of this, it's no wonder Mam-ma isn't remembering her medications... she has too much else on her mind, from embroidery to parties to peanut brittle! The aide also told me that Mam-ma nearly killed herself making THREE BATCHES of sugar cookies for the cousins who came. But she truly did enjoy them, so I guess it was worth it.
When I left my grandmother's house, I still had to return to Wal-Mart for OUR groceries. Also on my list was another box of diapers for the baby, plus formula and baby food, and a child car safety seat. I had to laugh... as I loaded my groceries into the car, I opened a door to set the car seat inside, and there was the walker. Now if I'm not covering both ends of the spectrum, nobody is! And we get to do it all over again this week!
Saturday, November 7, 2009
When the Medicare Part D Prescription Drug Plan was enacted in the fall of 2006, I selected what I felt was the best plan for my grandmother. Shortly after January 1, 2007, I discovered that Medicare had "switched" my grandmother to another plan without my knowledge - a plan that did not cover her prescription medications. It took some work and the assistance of a very helpful Medicare official in Dallas, but I was able to get my grandmother switched back to CignatureRx. This was not the end of the story... there were continual struggles with CignatureRx, because drugs they said were covered in 2006 seemed to mysteriously be "no longer covered" as the year progressed.
In 2007, I learned that CignatureRx was no longer a good fit for my grandmother, due to lack of coverage and the addition of premiums and deductibles. So I repeated the process to search for a new provider, and I chose Humana. I have to say, the folks at Humana were wonderful and very customer-friendly. They tried to tell me that two of my grandmother's most expensive medications were not going to be covered, but after hearing from her physician, they gave her a "lifetime waiver" on those drugs - she could receive these drugs for the initially-agreed-upon co-pay. I thought I was set! I learned in November 2008 that "lifetime waiver" was only good for one year - that in the insurance company's terminology, a "lifetime" equals one year.
Medicare employees confirmed to me in November 2008 that most seniors will have to re-apply for coverage EVERY SINGLE YEAR, due to changes in formularies, premiums, deductibles, and more. So once again, I am searching for an insurance provider that will adequately cover my grandmother's seven daily prescription drugs.
I know this is lengthy, but believe me, I have condensed it greatly. If you were to read my blog posts of February 2006 and November 2008, you would see some of the ordeal that has transpired:
Aside from the obvious concerns over how this is handled... here are my issues with this plan. I am a 52-year-old former elementary school teacher with a MS in Education. My husband and I founded a magazine and publishing business. I know how to navigate "red tape" and make appropriate contacts, yet I still struggled with this one. If getting prescription drug coverage is this difficult for me, imagine what it would be like for seniors trying to do it themselves. They get through two pushes of the menu buttons (and there are dozens!) and they give up and go away. I figure this is the hope of many of these bureaucracies. As concisely as I can make it:
- Medicare Part D is another example of how convoluted our health care system is.* The average senior cannot figure this out on his/her own, and I seriously doubt most have advocates to do this for them. Even four years into this, I still have to call my Medicare connection in Dallas for clarification and confirmation. I got this contact because initially I complained loudly to everyone from then Governor Mike Huckabee to Congressman Marion Berry, both of my senators, and others. Most seniors won't have the resources - or patience - to do this. (See my first blog post link for info on the responses - or lack thereof - I received!)
- I try not to let my grandmother know how much is involved in getting this coverage each year; however, sometimes she is required to verify information on the phone for representatives, etc., so she does know there is work involved. One day she said, "I'll just not take those medicines." I quickly told her this was not an option! But I fear that this is indeed what many seniors are doing... rather than fight the phone menus, comparing plans, and more, they give up and forego needed medications. This system is designed to shoot them down quickly and frustrate the seniors into quick defeat.
- The Medicare Part D Prescription Drug system is not equitable. So far, because of her meager "income," my grandmother has qualified for a waiver on premiums and deductibles on certain plans. Many others do not, and those premiums and deductibles add up quickly for older Americans on a fixed income. And what happens when the plans get so out of whack that my grandmother and others like her no longer qualify for waivers on these fees, as well?
- The "donut hole" is ridiculous. The mother of my mom's neighbor had to have an extremely potent antibiotic last January. The doctor could have given her injections, which would have been covered somehow by the insurance provider as a "medical procedure" perhaps. Instead, he prescribed oral medication - to the tune of about $3000 per month. This meant that this lady was thrown into the "donut hole" in February! I have a sick feeling this is in no way an isolated instance. Yes, it was a mistake made by the physician, but it shouldn't be possible. Physicians need to be treating patients, not keeping up with which forms of certain drugs are covered by insurance companies - and how!
Thankfully, I am now semi-retired and have more time to devote to keeping my grandmother in the necessary assistance to sustain her in her own home. We've done three stints in nursing homes for rehab following injuries and illness, and that is not where she needs - or wants - to be. And frankly, keeping her at home is far more economical for the federal government, in terms of capital outlay for her care.
The bottom line for me is that this system is not working for our seniors, and it's almost as if - as a nation - we don't care! As I understand it, presently the government cannot regulate premiums, deductibles, and formularies for the pharmaceutical companies. I believe it is time to revisit this situation... and maybe this is where the public option could help... something that seniors could choose that would cover their medications without imposing these fees and restrictions. I wholeheartedly support the President's health plan, and I believe that, sadly, this fiasco with Part D coverage is only one small part of a much bigger problem. But it is one that desperately needs to be addressed.
Wednesday, October 28, 2009
We got to the beauty shop, and I went in ahead of Mam-ma and asked the hairdresser, "Do you have time to do a perm? Mam-ma is saying she wants one, but I wasn't sure that would work for you." I know the hairdresser is rearing her grandson, and he goes to a daycare, so she might have to make arrangements for him to stay later when this happens. She insisted it was okay, but she wished she had known and we could have come earlier. I told her, "I just found out as we got in the car. Seriously, if it's not okay, just say so and we will wait." She said it was fine, but we would have to work around other clients, and it would take at least 2½ hours. So, I headed out to grocery shop and run some errands with plenty of time... even took in the Homecoming parade that was blocking my route.
I had just about finished shopping when my cell phone rang... the hairdresser... they finished in 2 hours. So I hurried to load my groceries into the car and make the trip back downtown to the beauty shop. I got Mam-ma into the car and started home with her, and she said, "I bet you were into something else this afternoon." I told her yes and no... that I had to get home to get supper ready so we could go to the ballgame. She offered me beans for supper... I thanked her and said I had already prepared a big pot of potato soup. I also mentioned that the baby was spending Saturday night and part of Sunday with us, because his grandparents were sick with the flu and he couldn't go to their house while his mother worked. She said, "Oh, you'll have the baby?" "Yes."
I was laughing that a friend had asked if we still keep the baby, and I told her we do, and she asked if that was still fun, and I said, "Of course!" Mam-ma said, "Well... it will start to wear on you." I told her keeping Timothy will NEVER get old to me... and she said, "Well you better enjoy it while you can." I laughed and as I got out of the car, I said, "Yes, there may come a day when he doesn't want to come stay with me," and I heard her mumble, "Yes, just like you kids. Someone asked me the other day, 'Polly, why don't your kids ever come to see you?' and I told them, 'They've grown up and they don't care nothing about me any more.'" I have heard this a thousand times, and rather than argue, I told her, "Mam-ma, when people grow up, they have responsibilities and their own lives to live... and they are simply busy."
Inside, we combed every closet for the elusive coat. She described it first as tan, then as khaki, and then as a light stone color, with a navy collar. I couldn't find anything like that. I called my mom and the drycleaners and neither had seen the coat. I told Mam-ma, "You've left it at Ruby's or at a domino party... call your friends and ask around." She said, "Ruby tells me all the time, 'Polly, you are always leaving your coat somewhere.'"
Trying to get home, I started to the door, and Mam-ma wanted me to look at her tomatoes. She has a big vine in her back yard with clusters of green tomatoes on it. A cold front had come through earlier in the morning, and she wanted to cover the tomatoes from potential frost. A blanket already surrounded the heavy wire cage supporting the vine. I said, "Looks like it's covered to me." She exclaimed, "Oh no it's not!" So I told her to get me a sheet and I would cover the tomatoes. "No, you won't!" she replied. "I'm going to do that." "Well I'm going with you!" I added. So she hobbled outside and got on the walker she leaves posted at her back door, and together we covered the tomatoes and pinned the blanket to the cage with clothespins.
Saturday, our phone rang... Mam-ma. "Do you have the baby?" "No, he isn't coming until around 1:00 p.m." "Oh... well... I found my coat!" I asked where it was, and she said, "In my closet. I had just simply overlooked it. I got up at 3:00 this morning determined to find that coat... and there it was." Then she added... "I bet you were cooking lunch." I told her no, I was watching the Razorback game. "So am I!" she said! She told me a few other things and then said, "I'll let you go watch your game." A few hours later, she called again... "Did you get the baby?" "Yes, he's here." "How was the game?" "We lost." "Well, I had company and had to turn it off, so I didn't know. What was the score?" I told her. "Well, I had company, so I didn't know... now I do." Click... she had hung up. And it clicked with me - she is jealous of the time we spend with the baby! Now, that's not all of it, but it's a big part.
At the ballgame, I sat behind my mother and grandmother's pastor... a man a few years older than I whom I have known all my life. He had visited Mam-ma recently. He introduced me to some church staff members sitting next to him, and the woman said, "Oh, I've heard a lot about you!" I asked from whom, and she said... "Your mother." I laughed and said, "Good... then it was probably nice things. If you had said my grandmother, I would have worried." I shared my afternoon experience and my grandmother's comment that we don't care and don't come to visit. My pastor friend shook his head. Then he laughed and said someone had complained lately when he visited her that he didn't come often enough - that he should visit her every week. He said, "I told her, 'You don't want to be sick enough for me to visit every week!'"
My mother got a call Monday from Mam-ma, and a cousin had said, "You ought to take a picture of those tomatoes!" Mam-ma was wanting to know if Mom had a digital camera. Mom offered to take pictures on Wednesday... what was she thinking?! I told her, "Mam-ma will expect that photo to be in the local paper!" True to her word, she went to my grandmother's today and photographed the tomatoes! I'm sure my cousin commented in passing, but Mam-ma internalizes everything!
Friday we go to the cardiologist for our check-up. It's supposed to be storming and flooding... seriously - like 5-7 inches of rain! My husband has graciously offered to drive us (or row us there?). Wish me luck... I'll let you know how we fare!
BTW... our darling Timothy DID spend much of the weekend... we didn't sleep much, but we were so blessed by his smiles.
Friday, October 16, 2009
A little after 4:00, Mam-ma emerged, no worse for the wear, but she mentioned in the car that "they really worked me over," and "they mentioned something about a valve problem, but they said the doctor would have to look at all that." We stopped on the way home for Mam-ma to select four pots of mums, which she wanted to set out around her pine tree with her other flowers. When we got to her house, I set the mums around the tree and asked if she planned to put them in the ground. She said, "No, I'm gonna dig around those pots so they will sit up better." Now, some of you will recall my failure at gardening to suit my grandmother last spring, so I didn't even dare offer to do this for her. Greg mentioned that "She has no business doing that herself," but he knew that she would not be happy with the efforts of anyone else. Besides, she had another project for him!
A week or so earlier, Mam-ma had called to talk to my husband. She said, "I need him to look at my bell on the front porch." I investigated when I went to do errands, and it was actually her wind chime. The clapper had broken off... well, actually, the string holding the clapper had rotted. Every time I tried to tie the wooden clapper back on, the string broke again. I finally managed to get it tied successfully, but it was several inches higher than it should have been and did not catch the wind well to clang the pipes and make the "chiming" noise. So when we returned from the doctor's office, Mam-ma told Greg, "I need you to look at that bell. Me and Debbie worked on it and we just messed it up." Now, there was no we in that deal... it was just me, and I was not aware that I messed up anything. However, a few inches of nylon string attached to the rotting string to extend the clapper beyond the pipes, and Greg was the Golden Savior of All Things Wind Chime!
Today, I went for the regular errands - grocery shopping while Mam-ma got her hair done. Her hair appointment is at 2:00 p.m. and usually lasts just over an hour. Mam-ma trudged along with her walker, and it seemed to me she was moving quite slowly today as she traveled from the car to the building and back. Once we left the beauty shop, she said, "I want you to tell me what they said about me at the doctor's on Monday." I explained that nothing was said - we just went for the test - and in two weeks we will return for the doctor visit and see what he says. She said, "Well, they scared the 'far' (Ozarkese for fire) out of me! They really worked me over, and Kathy even came in, and she never comes in!" I asked her what they said, and she repeated that the techs mentioned something about a valve, and "it scared me half to death!" So I said, "Well, first of all, it's now Friday, and that was Monday, and if anything were seriously wrong, someone would have called already. Every day you don't hear something is one more day you don't need to worry." Then I added... "Hopefully, if there IS something there, it can be controlled with medication." I asked, "If there was something that required surgery, are you up for that?" Mam-ma retorted, "Well NO! I'm not having surgery." So I replied, "Then I wouldn't worry about it. IF you have something wrong, they can either fix it with medication or they can't, so you don't need to worry about it." She said, "Well, I only lost one night of sleep over it!" I told her to quit worrying - we would find out what, if anything, was wrong in 2 weeks.
We got home, and I set her groceries on the counter and sat down to dispense her medications for the next 2 weeks. Mam-ma said, "Oh, I have a telephone message... I bet it's Ruby. She wanted me to go to Wal-Mart with her and shop for groceries when I got home from the beauty shop." I thought, "Hmm... I just CAME from the grocery store!" but I let it pass quickly. Ruby's message said something to the effect of, "Polly, it's 3:00... where are you?" Mam-ma called Ruby and got HER machine, so she left a message that we were back from the beauty shop. A few minutes went by, and Mam-ma put away her groceries while I worked on the medicine. Then she said, "Ruby wants me to go with her to Wal-Mart to look for some of those good apples I bought." I told Mam-ma that Wal-Mart was really low on produce today, and I had not seen this specific bag of Michigan apples she wanted in several weeks. But I added... "I bought some apples earlier today at the farmer's market, and they are so good... let me give you some of these. I've been meaning to share them with you." She said, "Well, I bet they are HARD!" I assured her they were not hard... and that if she would slice them, they would be plenty soft for her to chew.
I dashed out to the car and got her a couple. I brought them in and showed them to her, and she said, "Well, they're gonna be hard as a rock." I assured her again that they were NOT hard apples, and that we really liked them. She said, "Well, I'll just slice one and see." So she did, and the next words were, "Why, these aren't hard at all!" I told her I knew that, and she said, "This is delicious.. why, this is one of the best apples I've ever eaten... these are better than the ones I got! You can just get me some more of these!" So I went to the car and got the rest of my apples for her and told her I'd get some more for us later.
Meanwhile, Ruby had never called back, so Mam-ma declared, "She's gone on to Wal-Mart without me." She absolutely went into a tizzy like a little kid. I assured her that Ruby would not do that, and maybe she was just not able to answer the phone. "Well, I'll call again," Mam-ma said. And when the second call resulted in an answering machine recording, she left her name and hung up and said, "Well, she went without me." I told her Ruby would not do that, and she said, "Well, she said on that telephone message, 'it's after 3:00!'" I told Mam-ma, "I bet she's on her way over here now. She'll be here soon." "Well, no she won't!" Mam-ma retorted. "She's done gone to Wal-Mart!" I'm thinking, "So what?! You have apples and all of your groceries." But I could see she was really upset that her friend had gone without her.
I finished with the medicine, visited the restroom, and gathered my keys and cell phone. I still had to go to Wal-Mart for my own groceries, but I thought I would visit my mom first and hit a consignment store downtown and see what new bargains might be there. I put on my jacket and looked up, and Mam-ma was getting a cardigan sweater out of the closet. "Are you cold?" I asked. "No," she answered... "I'm going with you to Wal-Mart to meet Ruby!" Now, I could have told her I didn't plan to go straight to Wal-Mart, but I knew that would make her furious, so I just said, "Oh... well... how do you know Ruby is there?" "Well, I just know she is," she said. "And what do you plan to do if she isn't?" I asked. "Well..." she answered... "I guess I will walk home." I laughed and told her, "Okay... if Ruby isn't at Wal-Mart, I will bring you back home. But I have a LOT of grocery shopping to do, so it's going to be awhile." "That's okay," she said.
Then she added, "Wait just a minute... let me call ALPS." Now, ALPS is a discount grocery store that Mam-ma and Ruby love to frequent. "She might be there." I looked over and Mam-ma is sitting on her couch with the phone book, looking up the number for ALPS. The lady answered, apparently, and Mam-ma said, "Is Ruby XXXX there?" I don't know what the lady said, but Mam-ma said, "Can you ask and see if Ruby XXXX is shopping there?" Apparently they paged Ruby... but she was NOT there! So Mam-ma said, "Well... she's at Wal-Mart!" She slung her purse over her shoulder and got her remote for her garage door, and we started to leave. I asked, "Don't you want to take your good walker, in case you need to sit down?" She answered, "NO! I'm gonna push a buggy." Out in the garage, I tried to get her to take her aluminum walker that folds up... "NO!" she said adamantly, meaning she wanted to hold onto my arm for support - which meant if she hooked up with Ruby at Wal-Mart, it would be RUBY's arm she held onto for support to get home! Now for those of you who don't remember, Ruby is all of NINETY-ONE years young! Spry for her age she may be, but this is really unfair responsibility to impose on her.
Still not wanting to start WWIII, I complied and walked Mam-ma to the car. We drove the few blocks to the highway, then braved the after-school-on-Friday-afternoon traffic and headed to Wal-Mart. Just before we hit the turning lane for the store, Mam-ma said, "I bet Ruby is at the Ford place. We were going there, too." The Ford place is another quarter mile down the highway. "What were you going to the Ford place for?" I asked. "To get our money!" she answered. The Ford dealership is having a giveaway promotion. Every resident in the county, apparently, got a flyer with a key that might unlock a new car... and an offer to stop by for three gold one-dollar coins - and evidently the chance to win $500 in a drawing. Mam-ma and Ruby had done this once before, and she had given my sister and my niece and I each a gold dollar coin. It was a big deal to her.
I asked, "Do you have your papers with you for the money?" "Yes... right here in my purse!" So we headed to the Ford dealership. Now the owner is a friend of mine from church, and he was sitting outside on a bench, visiting with another man I know as an acquaintance. Mam-ma got out of the car as a very nice, tall young salesman approached... "Can I help you?" Mam-ma replied, "Yes, we're here for our money!" I wanted to die! I helped her get toddle inside, and the guy offered us a seat at one of many folding tables surrounded by metal folding chairs with balloons attached to them. The place was packed with people... many writing offers for new cars. The young salesman pulled out two registration forms, and I offered a seat to Mam-ma and said, "You sit here... I'm going outside to visit with the owner." I left her to fill out her form for the $3, and I went outside. I told my friend, "If you don't stop offering dollar coins to little old ladies, I'm going to have to whip you!" He laughed and said it had been great for business... "and she might even win $500!" I told him she had better not... that this would screw up the whole waterworks! He looked puzzled... clearly I need to explain to him what a windfall like that can do to seniors on a fixed income and Medicare/Medicaid!
So a few minutes later, Mam-ma emerged with her three gold coins, and a grin from ear to ear. She said, "That's three more dollars for Timmy (my new great-nephew, and her great-great-grandson)." I would have gladly given Timothy $3 to avoid this trip! Mam-ma went on to say that another friend of hers went and got HER three coins, "and she said she was going shopping and SPEND them!" Mam-ma said that with disgust, like there was something magical about these coins and spending them would be absurd.
We pulled into the Wal-Mart parking lot, and you can only imagine how many cars and people were there. It was now probably about 4:00 p.m., so people were there after school, work shifts, and many deer hunters were stocking up to head to their camps to prepare for the upcoming season. It was, in short, a ZOO! I told Mam-ma, "I'm going to let you out at the door and you can sit inside while I go park the car." "Okay," she said. I pulled up at the front door, and with motor running, I started to get out. "You don't need to help me," she said sternly. "Yes, I do," I replied. I helped her get out of the car, and I walked her into the entryway. I pointed to two benches and said, "Now you go sit over there, and I'll park the car and be right back for you, and we'll look for Ruby. Wait right over there." "Okay," she said, and I hurried to my car and tried to find a parking space.
It took me a few minutes to find a parking space, and when I got inside, the benches were not empty... Mam-ma was not there. "Oh, geez," I thought. My next thought was, "Okay, she was cold, and she's waiting inside by the buggies or the produce." Wrong. She was nowhere to be seen. My heart was in my throat. Where could she have gone? I grabbed a buggy and put my purse in it and started looking around. Then, out of the corner of my eye, and wayyyyyyyyyyyyyyyyyy off in the distance, I saw a streak of white hair. Mam-ma was at the very BACK of the store near the fabric department. How she got back there so quickly was beyond me, given how she had toddled into the beauty shop a mere hour or so earlier!
I quickly started making my way through the people toward the back of the store, and by the time I got to where I had seen her, she was long gone - to the dairy case! I finally caught up with her there, and called to her, "Mam-ma!" Now, Mam-ma can't hear well at all any more, so I had to shout, and many of the people around me turned and stared. Mam-ma looked up at me like I was a space alien and said, "Huh?" I said, "Mam-ma! You scared me!" She looked so puzzled, and I said, "You were supposed to wait for me at the front of the store, and when I got in, you weren't there... and that scared me! I didn't know what had happened to you." "Oh I was?" she asked, as if she had never heard this before. Now I knew people were staring, and I felt like the mother of a three-year-old who just got caught pilfering grapes from the produce aisle. "Why didn't you wait?" I asked... but I already knew there was no answer... at least none that made sense.
So I told her, "I don't think Ruby is here." "Well," she said, "I need some butter." Okay, so butter was NOT on her list today... and she started looking at the butter. I told her, "I have a lot of shopping to do." "Well, go on," she said. "I'll be alright. I'll make my way back to the front of the store." I looked her square in the eye and said, "I will meet you at the front of the store when I'm done, but it might be awhile... " She said that was fine, and I asked, "You WILL be at the front of the store?" Yes, she said she would... and again she told me to go on and not worry about her. Yeah, right.
I started making my way up and down the aisles, my heart still beating faster than it should, and I was wondering the whole time... "Where is she? Is she okay? Will someone bump into her and knock her over?" About four aisles later, I look up, and there is Ruby. "Ruby!" I said, truly glad to see her... and by the way, she looked stunning in a beautiful tweed jacket and slacks, rhinestone pin on the lapel and her hair freshly styled. "How are you?" Ruby asked. "I'm not sure!" I answered. "I have Mam-ma with me - she's come to Wal-Mart to meet you!" Ruby told me that when Mam-ma did not answer at 3:00, she went on to Fred's to pick up her prescription medicines. She said, "I thought I would drive back by Polly's and surely she would be home and ready to go, but when I got there, she didn't answer her doorbell or a knock on the door, and I got worried something might even be wrong with her." I apologized and explained what had happened... and how Mam-ma had scared me by not being where I left her and dashing to the back of the store, and Ruby said, "She does that to me all the time. I drop her at the door and go to park, and when I get inside the store, I can't find her anywhere... she's already taken off somewhere!" I felt so bad to think Mam-ma is so inconsiderate of her dear friend.
Ruby told me that she would catch up with Mam-ma, and if I saw her at the front of the store, to tell her to wait there for Ruby. I continued shopping, making my way toward the front of the store. When I got there, Mam-ma was in a check-out line, and she had a bag of items. I don't know what she had, because she had already checked out. I walked over to her and told her I had found Ruby, and that she was to wait at the front of the store for her to get finished with HER shopping. Mam-ma froze in her tracks, trying to hear what I was saying and blocking customers behind her. I finally got her moved away from the register, and I could feel a cold blustery wind blowing in from the entryway. I said to Mam-ma... "It's too cold for you to sit on those benches... you aren't dressed warmly enough." She nodded in agreement. "That's okay, I'll wait inside." I reminded her she would have to stand up, kicking myself for not insisting she bring her walker. "That's okay," she said. I finally had no choice but to leave her and go ahead and finish my shopping. I thought about taking her to the deli to sit at a table, but then Ruby would not know where she was. So I left her.
I hurried through the rest of my shopping, but when I returned to the cash registers, neither Mam-ma nor Ruby were in sight. As I walked out of the store, I dialed Mam-ma's telephone number... and Ruby answered. She assured me that they had just gotten home and she was helping Mam-ma get settled. I thanked her and sighed a big sigh of relief. And God blessed me with His favor - the produce stand was still open a little after 5:00 p.m., and I was able to get more apples for our own table.
In retrospect, this is more funny than it was this afternoon. I am also amazed when I consider that my grandmother was like a blaze of lightning pushing that grocery cart, particularly in comparison to her speed behind the walker. I told my mom later, "If there was a way to fold it up and put it in the car for transport, I'd buy her a grocery cart and ditch her walkers!" Still, she would not have a place to sit. Don't even suggest she use the motorized carts at the store. I used one of those when my ankle was broken, and let me tell you, driving them is an ART and takes skill and coordination! They are not designed for 97-year-old grandmothers!
I am not so naive as to think that my "weekly shopping" for Mam-ma comes remotely close to stocking her pantry and refrigerator with everything she eats. I know for a fact she and Ruby go numerous times per week to shop for a handful of items. But this is not the first time that Mam-ma has beat me back to Wal-Mart... but it IS the first time I have driven her there for Trip #2! Clearly she is recovering well from her bout with shingles... and apparently a big part of her anxiety about the trip was getting to the Ford place for her three dollar coins! But I was amazed at HOW anxious she grew... fidgety, almost panicked, when she thought Ruby had gone without her! And again, as with trying to reassure a three-year-old, I could not convince her that Ruby would be along in a few minutes. While I was dispensing medications, I thought to myself, "I'll see these two again in Wal-Mart. Ruby will come by right after I leave and get Mam-ma, and they will probably beat me there today!" Had we waited a little bit longer, Ruby would indeed have been there to get my grandmother.
In retrospect, I realize I should have put my foot down and told Mam-ma that I was not going straight to Wal-Mart and let the chips fall. I told Mom I could hear her little voice saying, "This is a bad idea!" But I also know how in knots Mam-ma gets and how upset I get when she gets mad and ugly, so I took what I thought would be the easier path. What was I thinking?! I thank God that it ended well and everyone got home safely. Greg said, "Well, she yanked your chain good today!" My mom said to me, "Look at it this way... you don't have to do this again until next Friday!" Let's hope so!
Wednesday, October 7, 2009
I told her to go move the plates and look - maybe they fell over behind and she couldn't see them. She said she would do that, and I could hear her moving into the kitchen with her cordless phone.
Then I heard her housekeeper say, "Ms. Polly, is this them?" They were in her "box" on the kitchen table with her other pills. Yes, that was the ones. She said again, "Well, I just figured you took them so I wouldn't have them here." I assured her that no, I picked them up at the pharmacy and took them to her and set them on the kitchen table, and that was the last I saw of them!
I asked, "You will only take half a tablet, right?" "Well, I'm gonna call him and see what he thinks." "Him who?"I asked. "The doctor." I told her, "I can tell you what he thinks, because he wrote it on the bottle... he wants you to take one tablet every six hours, but you said you had never taken a whole tablet, so we agreed to start with a half, right?" "Well," she said... "these are different... they don't look like the last ones he gave me." "Then you should definitely start with half a tablet," I told her. "There is no need to call the doctor." She said okay...and I assume that she only took the half. I do know "through the grapevine" from another family member that she told her a few days later she had not taken any pain medication in two days! So hopefully this is on the mend.
My sister took my new great-nephew to visit Mam-ma on Sunday, and Mam-ma cooked lunch. She and my sister fed the baby mashed potatoes and homemade chocolate pudding. He's only 5 months old, but he has just started eating mashed table foods. My niece was not thrilled with the chocolate pudding sampling, but you would never convince my grandmother that there was anything wrong with it! My sister said that Mam-ma got down in the floor to play with the baby and was able to get back up without any assistance, so that's pretty good for 97 years young!
The "wrinkle" yesterday was dizziness. My grandmother told my mom she was "drunk" and that she thought it was her inner ear. She insisted she had not taken medication that could cause this... but she did take some medicine she had on hand for an inner ear infection. Today she was much better... but now her teeth are hurting again. Mother talked to her about eating better... perhaps eating peanut butter for the protein. She IS having me buy her Ensure at the store now... I guess she uses it to wash down her chocolate chip cookies and Three Musketeers bars! We have laughed... my grandmother hardly ever ate anything chocolate, and now she is getting the candy, the cookies, chocolate pudding mix, and chocolate Ensure... and a six-pack of 20-oz. Cokes nearly every week. On the other hand, a friend told me that if she makes it to 97, she is going to take up smoking and sky diving! I guess at this stage, Mam-ma has earned her chocolate and colas... but I'm still not sure about the little red pills.
Monday, September 28, 2009
I talked with my mom, and she said, "I know what you are going to say... Mam-ma called here around 1:00. I told her I would be gone, and you would have the baby, and she said she was going to call her friend Ruby." It's always the same thing - Mam-ma waits until her dentures are so loose that they are rubbing a terrible blister on her gums, and then it is an emergency of national proportions. I guess I am not sympathetic because I don't wear dentures, but Mom says it's really miserable pain. However, she agrees that Mam-ma waits too long to have something done... and the dentist even fusses that she should come more often for adjustments.
As luck would have it, my sister was able to take Mam-ma to the dentist. I say "lucky," because the baby ended up staying into the evening and being fussy. And, Mom's husband had also offered to take Mam-ma (and I'm sure my own husband would have taken her, had I asked.) My sister said they were in and out of the dentist's office in around 30 minutes - something I have never experienced! She also said that on the way home, Mam-ma said, "The dentist fussed because I don't come to see him about these teeth more often, and I told him, 'I would, but I don't have anybody to bring me. My friend Ruby would bring me, but she works.'" My sister couldn't believe Mam-ma said that... welcome to my world! My sister put Caladryl on Mam-ma's shingles, and she said they were all dried up except for a small patch under the breast. She thought Mam-ma looked well and was feeling well.
Friday afternoon, I took Mam-ma to get her hair done. She mentioned on the way home that she had taken an Ibuprofen before she went because, "I was hurting a little." I reminded her that shingles can hurt off and on for a long time, and I suggested that she take TWO Ibuprofen before bedtime and get a good night's rest. She replied... "Well, the thing of it is... they hurt my stomach." Now, I know this is possible. I also know that Mam-ma doesn't take her pain medication with food... AND... she has been terribly inconsistent about taking her Ibuprofen. Several medical professionals (and my mom and I) have recommended she take her Ibuprofen with some crackers or cookies or something EVERY THREE to FOUR HOURS, to keep a steady dose of pain medication in her system. Clearly she doesn't need as much as she implies, or she would be more diligent in doing this. She may be forgetful about some things, but I don't think pain medication is one of them.
Mam-ma also told me that her friend Ruby had said, "I will be so glad when you feel like going shopping with me at the grocery store again." I suggested that Mam-ma should be able to do this already, and she said, "Well, I'm just about there." Less than 30 minutes later, I asked her if she was going to church Sunday and she said, "I don't know... I went to that thing at church yesterday." I questioned her, and she said, "You know that thing at that little church - your doctor was there." I said, "Dr. XXXX?" "No... your kidney doctor." "Oh... Dr. C." "Yes, and he spoke and it was so low I couldn't hear any of it." "What did he talk about?" "Well, it was real interesting... he talked about the wars and such... I wish I could have heard it." "And where was this?" "Oh, at that church next to Alps - Grace Baptist." "Who did you go with?" "Ruby. And I tell you what... that was the prettiest singin' I ever heard. Cleta and Carolyn (two sisters she knows) and about four men... and then her husband got up and sang a couple of songs." I said, "Gospel music?" "YES!" "And you like that..." "I love it!" My sister was amazed to learn that Mam-ma had been somewhere Thursday morning... and this was on the heels of Mam-ma telling me how badly she hurt and how Ruby sure hoped she felt like going to the grocery store with her soon. For all I know, they went that day!
It turns out that Mam-ma went to the church service on WEDNESDAY morning... not Thursday. And... Mom said that a lunch was served. So in retrospect, Mam-ma barely got home from her church service and lunch before she was calling Mom and me in desperate need of a trip to the dentist! I have no doubt that she was the life of the party at the church function... a totally different picture than was painted for us a few minutes later.
At 5:00 a.m. on Saturday, our phone rang! My husband answered first, and when I got on the line, Mam-ma was already asking him, could she take "one of them red pills." I asked what was wrong and she said..."Would it be okay if I take one of them red pills? I haven't slept a pat all night." (She was sounded horrible, of course.) She added, "This under here is just a hurtin' me so bad." (I think she is talking about the little patch still under her breast... and I have no doubt that it hurts.) I asked her, did she plan to only take a half a tablet? She said, "Well, when I talked to him at the drug store the other day, he said it would be alright to take one." I don't know who him is... or when she talked to him, but I told her, "But you told me you have never taken more than a half a tablet at a time."
Then I asked if she took an Ativan Friday night before bedtime, and she said yes. I asked... "Did you take a half or a whole one?" She said, "Yes." I asked, "Which one, Mam-ma - did you take a half or a whole?" She said she took a half. So I told her "Then, yes, you can take a half a Darvocet - but ONLY a half a tablet, and you need to eat something with it - and then you get back into bed and see if you can sleep." Honestly, I have no clue whether she was really that bad - how much she had actually slept - or how much of her tone was for my benefit... but it sounded like she had worked herself into quite a lather, and I knew she would probably take the Darvocet either way, so I told her to go ahead.
I waited until about 10:00 a.m. to call, hoping Mam-ma had gone back to bed and was sleeping. She had not. She said she had company - church friends who visit nearly every day - so we didn't talk long. She was talking about taking the other half of the Darvocet and getting back into bed. I don't know what she did... I didn't call again. Her voice was strong, and she didn't sound like she was in pain... or even fatigued. Most likely she slept more through Friday night than she thought - or admitted.
I am trying to learn from all of this. My maternal grandmother was notorious for middle-of-the-night "emergency" phone calls to my mom for a myriad of concocted problems... sometimes demanding to be taken to the ER... so this phone call wasn't that big of a deal in the scheme of things. But I wonder, is it the first of many to come? I don't think my grandmother had a clue what time it was - and if she did, she didn't care. She had clearly worked herself into a state, and I know this can be hard on her heart and/or cause her to have a stroke.
I know that there are those who (with help and stories from Mam-ma) think that I am uncaring and unwilling to help her. And neither could be further from the truth. They don't see the happy, determined woman who goes to a community church service one hour and calls in a panic the next declaring she is "hurting so bad something has to be done." They don't know that the little woman who tells them she hasn't slept a wink and hurts so bad she is walking the floor probably did 2 loads of laundry, baked a pie, walked around the block, and made a batch of peanut brittle -- all before 9:00 a.m.! The little woman they see hobble across the floor on a walker is the same one who picks up limbs in her yard, sweeps her carport, and fertilizes her flowers (all against our better judgment - and mostly behind our backs!).
I recently went to the funeral visitation for an 80-year-old lady who suffered a heart attack, aneurysm, or something instantaneous as her husband helped her stand beside her bed to make a middle-of-the-night bathroom run. While the lady had been physically incapacitated and confined to a wheelchair and her bed most of the time, she was still mentally alert and well. Her husband, on the other hand, is fairly well physically but can't remember to take his medications and is failing mentally. Together, they sort of made a "whole person" - and this is often the case. I looked at the frail, teary-eyed widower and thought, "you are probably a good 15 years younger than my Mam-ma!"
I know age is relative, but I see so many people who are far younger than Mam-ma doing so much more poorly... and I marvel at how well she is. I wish she saw it! And then there is her friend Ruby - almost 91 and still working for another elderly lady two days per week, mowing her own yard, and driving herself and others to countless meetings, events, and the local grocery/discount stores... and I know she has health concerns, but I do not hear her complaining. Could it be that she complains to her children/grandchildren and paints a rosey picture to HER friends? I don't think so... but I can't say that for certain.
I try to learn from these experiences. So what are my lessons from this weekend?
- I am trying to do all I can to be self-sufficient... and to stay that way as I age. I am striving to remind myself often how strong I am... and to keep busy and focused on others more than myself. I firmly believe that a big key to helping yourself is to get busy helping others. And I see this confirmed in my grandmother... when she is busy attending a church service, cooking for someone, visiting with company, helping Ruby with a project, making baby quilts for her great-grandson and countless nieces and nephews, or even talking on the phone with her friends, she tends to forget herself - if only for a few minutes.
- My grandmother's laundry list of ailments and complaints is miniscule compared to the needs and ailments of many much younger than she. She continues to do remarkably well - and I have no doubt it is in large part due to her feistiness!
- It doesn't matter what others think... they are not in my shoes, don't know my situation, and they don't get the whole story from my grandmother. I reminded myself of this at Sunday lunch, when the daughter-in-law of Mam-ma's friend asked, "Have you talked to your grandmother today?"
- This is a process...and the best I can hope for is to meet needs, put out fires, and keep putting one foot in front of the other and doing what is necessary to keep my grandmother safe and able to live alone in her own home.
As our population on the whole ages, I wonder what lies ahead... for us AND those who care for us! And I wonder what this week will bring! I probably need to read some posts at AARP.org on the Caregiving forum... the daily challenges others face always humble me. Or maybe I'll go make some burp pads for our great-niece who will arrive in November. Doing for others... yeah... I think that's the ticket!
Saturday, September 19, 2009
Tuesday, I got Timmy down for a nap, and my phone rang - Mam-ma Polly. She sounded AWFUL and said, "The nurse just left to go get me some pain medicine... this Ibuprofen is not doing enough." I asked what nurse... and she said Home Health. I asked WHAT medicine, and she said, "Darvocet." I then reminded her that about a month ago, Dr. B said "No more Darvocet," and I removed it from her house - so who prescribed this? She didn't know... but the nurse was headed to the pharmacy. So I called the drugstore, and the clerk asked the pharmacist, and he said, "That prescription has been sitting here for 5 days."
Meanwhile, the nurse arrived at the pharmacy (the clerk said "I think she's standing here at the counter.") and I explained that my grandmother wasn't supposed to have Darvocet, and this was all news to me, and I needed to talk to Dr. B. So the pharmacy people told the nurse there was nothing to pick up, and if there was something later, I would get it. The pharmacy clerk also told me that Calamine lotion had been ordered. I told her I had a bottle of Caladryl in my purse already to take to Mam-ma, and she said, "Well, you certainly don't need the Calamine, then... I'll tell the nurse there is nothing to pick up."
So... I called the clinic, and I talked to the receptionist, who happens to be the doctor's wife. That was before 2:30 p.m. She looked at Mam-ma's chart and said, "Last Thursday, the Home Health nurse called and reported you had had Polly to the ER on Wednesday and she was disoriented and vomiting. She is not disoriented today, but she is in pain. The doctor personally called in a prescription for Darvocet."
Nobody ever let me know about it - and nobody picked it up. I also told the doctor's wife that Polly was INDEED disoriented on Thursday, which is why my sister spent the night with her. So I don't know what story Mam-ma gave the nurse or how she acted. The doctor's wife acted very sympathetic and understood Mam-ma could not take Darvocet with Ativan, and she said she would talk to the doctor herself and call me back. No one ever called back, so at 5:00, I called the clinic again and was put through to a nurse. She said, "Well, we told the doctor you called, and I guess we assumed you were just wanting us to know you weren't going to pick up the Darvocet." I told her no... that the doctor's wife had said she would talk to him and call me back. The nurse started in about how Darvocet was the ONLY thing that would cut the pain of shingles, and "I can tell you, if she has shingles, she is in pain."
I told her I was really upset that Dr. B told us recently she was NOT to take Darvocet, and then last week he called in a prescription for it... and on top of that, nobody told me! So if she made it all weekend without the Darvocet, how bad did she really need it? The nurse repeated for the umpteenth time "All I can tell you is if she has shingles, she is in pain, and Ibuprofen won't cut it... she needs Darvocet." So finally I asked if there was anything in between Ibuprofen and Darvocet, and she said, "Motrin is not going to cut the pain." I reminded the nurse that my grandmother takes Ativan, and Darvocet and old people doesn't go well (much less with Ativan), and we couldn't risk a fall, and she said, "Okay, let me ask you this... do you live in town?" I told her yes, and that Mam-ma lives in town, but we don't live together. She said, "Well, why couldn't you go stay with her for a week or so while she takes the Darvocet?" I told her, "You just don't understand... there are extenuating circumstances, and no, I can't go stay and neither can anyone else. Besides, she doesn't want us there." The nurse said, "Well, then, couldn't you bring her to your house?" I told her again, that no, there were extenuating circumstances, like I live in a 2-story house (not to mention that I keep a 4-month-old baby that can't be exposed to shingles!). She said, "Believe me, I understand, but you have two choices - she can take the Darvocet or be in pain."
Finally I told her I would talk to Mam-ma and if we needed the Darvocet, I'd go get it. I called my mom, who had just gotten home from a trip to Branson, and we talked it over, and we agreed that Mam-ma's body is under stress from the pain, so I should go get the Darvocet. I did, and get this - her Medicare Part D wouldn't cover it, because Darvocet is not authorized by Medicare for coverage for anyone over age 64! So I paid the $13.80, and the girls in the pharmacy told me how shingles REALLY DOES hurt, but they were nervous about the Darvocet... although one of them pointed out it was Darvocet N100 and "very mild." Yeah, whatever... it's still Darvocet!
So I get to Mam-ma's with the Darvocet, and she says, "Well, I'm not takin' that!" So... tell me... why did I get it?*lol* I explained that her insurance would not authorize payment since she is 97, and she said, "I've never taken a whole one - if I get desperate, I might take a half, but I'm taking Ibuprofen every 3 hours instead of 4 and doing just fine." So what was the deal at 2:00, I wonder? I put Caladryl on her shingles and left. Her shingles have broken open and even scabbed over some, so they are moving right along.
So I went to Mom's to tell her this, and she asked me again if I thought Mam-ma could take TWO Ibuprofen at a time. I called my sister-in-law (who is a pharmacist) and asked her, and she said yes - every 4-5 hours, but not every 3. I told Mam-ma that, and she said she would do this if she needed them. I know her BP is up and this is hard on her heart to hurt, but I pointed out to the nurse that we didn't have that Darvocet all weekend because I didn't even know it was at the drugstore, and she made it just fine without it, and the nurse said, "Well, I can guarantee you, if all she had was Ibuprofen, she was hurting." In other words, we are all big heels for being so mean to Mam-ma! I don't think so!
So... Mam-ma has the Darvocets, but so far she has not taken any. My sister-in-law agreed that if Mam-ma isn't remembering to take Ibuprofen every 4 hours, she can't be hurting THAT much... not enough to need Darvocet. AND... she said there are 400, 600, and 800mg prescription strengths of Ibuprofen... so there IS something besides Darvocet! I'm still upset with Dr. B for not paying closer attention to this - and it bothers me that the Home Health nurses can go get medicine for Mam-ma without me knowing about it. Funny they can do that, but they can't take her to the clinic for a dr.'s appointment!
Wednesday, Mam-ma said she took 2 Ibuprofen the night before at bedtime and got a really good night's rest. Wednesday, she only took 1 tablet at a time, but said she would take 2 again at bedtime. However, she said her legs were wobbly - and she blamed it on the 2 Ibuprofen (more likely it was the whole Ativan tablet she took during the day on Tuesday after a half tablet the night before!). I said, "Imagine if you took the Darvocet!" She said, "Now that Darvocet doesn't bother me... and I only take a half a tablet..." But she assured me she would NOT take it.
It is so frustrating dealing with doctors. And I did not need a lecture from that nurse. I think it was a CYA thing, but nonetheless, I was not a happy camper. It just blows my mind the messes doctors can create... and I feel like Dr. B is avoiding me and giving me the runaround... and clearly he is not paying attention. But trying to change doctors at this late stage would be an ordeal, too... and I am not sure it would make any difference. I should have changed Mam-ma to my doctor years ago, and I can't remember for sure why I didn't, but I think she and Mom were not on board with it. Maybe my doctor didn't do rounds at our preferred nursing home. Such complications! Oh, well... If I am sort of on top of this and this much chaos occurs, can you imagine what happens with little old people who have no advocate? Sheesh!
Meanwhile, I did get my grandmother to the beauty shop yesterday, and she had made a grocery list... milk, buttermilk, orange juice, a big bag of Three Musketeers bars, corn meal, apples, and Cokes! I was surprised her Chips Ahoy Chewy Chocolate Chip Cookies were not on the list... hopefully she still has a stash! I dispensed her medicine for the next 2 weeks and noticed that it doesn't appear she has taken the doses correctly for the last week, but I'm not totally surprised by that. Anyway, she told me, "Before you leave, you can doctor my places again." So I donned a glove and applied a layer of Caladryl. And the shingles look amazingly better than even 3 days earlier. The red welts are gone, and all that is left is a little patch of scabbed places.
I asked Mam-ma if she was taking her Ibuprofen, and she said no - that she had not needed any all day! She said she was going to take some at bedtime, along with a whole Ativan. I questioned this, and she said, "Well maybe I will take a half a tablet, and if I wake up in the night and can't sleep, I'll get up and take the other half." My thought was, if you have to wake up in order to know you need another, do you really need it? Oh, well... she will do what she will do - even with us standing right over her - so I left her to her own devices. Hopefully she truly is on the mend, and things will start to look up from here. All I can do is try to keep tabs on her medication and pray that nobody does another "end-around" that results in a fall.
Thursday, September 10, 2009
The lull is officially over. I realized Wednesday afternoon that my grandmother didn't have enough medicine dispensed to make it to Friday when I planned to visit again and buy groceries for her. I had decided to run to the grocery store and do a couple of other errands for myself, so I made plans to go by her house and do the meds at the same time. My sister Suzanne and her husband Mike were there picking up the okra and tomatoes Mam-ma had called and offered to me earlier in the day (and I had declined). They left, and I did the medicine and was about to leave, when Mam-ma suddenly shuddered and said, "Hand me the trash can, I'm sick." Boy was she ever. She threw up so hard she literally threw out her lower denture! It's sorta funny now, but it wasn't funny then. She fished it out and cleaned it later while I cleaned up the rest of her mess. So, I called Home Health to see what I needed to do, and they said, "Call her doctor." Mam-ma's doctor doesn't work on Wednesday afternoons, so I called back and said, "You have to help me. I think it might be her Valtrex." They said, "You need to take her to the ER... she could be having a reaction. We can't diagnose anything."
So, I got Mam-ma changed into some pajamas, because she threw up all over her clothes, and I called my Mom and Suzanne (both of whom were shopping) to alert them to what was happening, and we headed to the ER. Suzanne and Mike were still in town, so they met me at the ER. Mom had said she would come when she and her husband, Lee, got done with some shopping... she never made it, because luckily, we were in and out. We saw a great ER doc who has seen Mam-ma before, and he said, "She is having and adverse reaction to Valtrex... not necessarily an allergic reaction." He also said that Valtrex can sometimes speed up the healing of shingles, but it is not a cure, and it wasn't worth it in this instance. He says that shingles is "a nursing problem" and we just have to try things like aloe vera gel, Aveeno, Caladryl, etc. - whatever works and alleviates the discomfort. He also said Mam-ma is still breaking out, and that can last 2-6 weeks, followed by months of pain.
So I took Mam-ma home, and Suzanne's husband picked her up and took her home. Mom offered to spend the night last night because she and her husband are supposed to go to Branson for several days. So she said, "Let me help while I can." I stayed until she arrived about 7:15 p.m. She said she finally got my grandmother into bed around 9:00, but she was soon back up for chocolate chip cookies (Mom said, "I didn't know this was a night-time ritual." Neither did I, but I'm not surprised... I know I buy cookies nearly every week!)
The thing is, Mam-ma was totally out of it, and we're not sure why exactly. Her BP was very high - 182/83 at the ER, and then 201/94 at home. That is probably pain. She says she has barely been able to see for 2 days now - that everything is blurry and out of focus. And when my sister called last night to check on her, she told her she had shingles and had been to the ER. Suzanne said, "Yes, Mam-ma, I know... I was there." Mam-ma said, "Oh you were?" I was sitting beside my grandmother saying, "That's Suzanne you're talking to..." but she didn't realize it, I guess. It really rattled my sister, but mostly, it just concerned her how confused Mam-ma was.
She was so wobbly it was like she was drunk. And yet she was having a FIT because one of us spent the night with her. I was heating soup on the stove, and she hobbled into the kitchen on her walker. I looked around just as she took a step and lost her balance, and she braced herself on the stove... literally INCHES from the open flame. She never realized it. I quickly grabbed her hand and moved it. She thought I was just offering a gesture of affection and smiled at me.
So, today... I had planned to go with Greg this morning to some meetings with our broker and insurance agent. However, our phone rang before 7:15... it was my sister. She said my niece was dizzy and had possibly passed out at home... my sister and her husband were taking her to the ER... could they bring the baby to us? Of course! So by 7:30 a.m., I had Timothy in his crib here, and I had called Home Health and asked could they send a nurse to check on Mam-ma? They said they would.
Mom e-mailed and said Mam-ma fixed her own breakfast - she insisted - and Mom hoped that was a good sign. Then Mam-ma promptly threw up what she had eaten in the kitchen sink! Mom was upset with her... seems Mam-ma took her morning meds BEFORE eating anything and insists she does this all the time. Mom has harped on her for 3 days to eat BEFORE she takes any medication. At 97, what are the odds she will change?
So the day is only a few hours old, but it's already shaping up to be a crazy one around here. My sister had said she would stay with my grandmother tonight, if needed... that may be out the window. We're just taking it one minute at a time. I knew that lull wouldn't last!
I rocked Timmy to sleep in his crib and sang "Over the Rainbow" - his Uncle Tim's favorite song. Timmy smiled and looked at me with eyes that gently drooped shut. Even after he drifted to sleep, his mouth formed a momentary wide grin. A friend commented yesterday that "little ones provide balance." God must have known I needed balance this morning... and He sent a perfect angel my way.
Wednesday, September 9, 2009
Here we go again with shingles... this time it is my grandmother. A little over a week ago, I suddenly got sick on a Sunday. I think it was the flu, but I didn't go to the doctor for a test. Since the CDC recommends that those who think they have the flu stay home and follow standard treatments for symptoms of the flu unless you are high risk, I stayed home and in bed. Honestly, I didn't feel like doing anything else for a few days. So by the end of the week when it was time for my grandmother's beauty shop appointment, I had prevailed upon my mother to drive her there. Thankfully Mom was home and not away on a trip.
Meanwhile, there was a "big limb" on the roof of my grandmother's porch that was driving her nuts, and on Wednesday, my husband took his ladder and went to retrieve what turned out to be a very small limb. Mam-ma said, "Well, that's not as big as I thought it was!" While my husband was there, Mam-ma told him all about how sick she had been for three days with diarrhea... and then she offered him peanut brittle she had made that morning! He politely declined. He told her I was sick and in bed, and that my mom would be handling the weekly errands.
Later that day, Mam-ma called, "to see how you are feeling." When I told her I was still sick, she quickly moved on to how bad she had felt... she had just been so sick. I told her that I heard she was getting better, and she said, "Well, maybe." She complained of a pain in her side... "up kinda high under her shoulder blade, near her chest and down her shoulder a little." She told Mom the pain was "in my side."
Thursday, she called and asked if I was better. I told her yes, a little, and she immediately moved on to her ailments and how bad she had felt. Again she complained of this pain in her side. This time it had moved... down her side. It moved every time she told one of us about it. We suggested she pulled something - she insisted she didn't.
Saturday, Mam-ma called and asked, "Are you better?" I told her yes, I was slowly getting better. She said, "Well...." then after a short pause, she said, "Well...." and, knowing what she wanted, I asked, "Are you better?" She said, "Well, no I'm not." She began to tell me again about the pain in her side and all around... shoulder blade, chest, neck, shoulder. I suggested she had pulled something and didn't realize it... she insisted she had not. She said, "I tried to go to the doctor yesterday, but they couldn't see me." I asked if the doctor was in clinic on Friday, and she said, "Well I guess... they told me he was so busy I would have to come and just sit." I suggested maybe she would be better by Monday and reminded her that with so much flu, she really didn't need to sit in a clinic... that I personally knew people in town who had been told by clinic staff, "DO NOT COME to the clinic... we have too many people here with flu and you shouldn't be exposed." I suggested she rest over the weekend and maybe stay home from church, telling her I planned to stay home on Sunday.
On Sunday, my mother told me that Mam-ma was at church. I assumed she was better. Sunday evening, she called me and again asked, was I better. I told her yes. She said, "Well, I am suffering so. Something has got to be done." She said she was still hurting, and again, I suggested she might have pulled something, and she said no, and she added, "I think it's my colon and my bowels." I told her that IF she went to the doctor for that, he would put her through GI tests. She said, "Oh, I don't want that." I didn't think so. She kept saying, "You just don't know how I'm suffering." I told her I was sure that was true, but I didn't know what to do for her... especially on a Sunday afternoon. I suggested she try to call a nurse on Monday, even though it was Labor Day. Mom and I hoped someone might be "on call." I told her that I could not risk sitting in a clinic and being exposed to the flu... and she shouldn't be either. She did not like that, I'm sure.
Sunday evening, Mom called... "I think I know what's wrong with Mam-ma. She has just called, and she has a rash under her breast and around her back. I think it's shingles." We both agreed that was probably the culprit, and Mom told her to put some Kenalog cream she had in her medicine chest on it and call her nurse the next morning.
Labor Day - no nurses! Mam-ma was beside herself. She called me and said at least 3 times, "You just have no idea how I am suffering!" I told her I was sorry. I asked her, didn't she have shingles once before? She said, "Well, I thought it was shingles, and the doctor said it wasn't." I said, "Maybe this isn't either," and she yelled, "Are you KIDDING?!" I can tell you, this is shingles! We finished our conversation, and later I had to call her back to ask her something, and she answered the phone very strongly, as if nothing at all were wrong. As soon as she heard my voice, HER voice dropped, and she began to whine and almost cry. It's always like this.
Mom and I both told her repeatedly to call her nurses first thing Tuesday morning and see if the nurse could diagnose the shingles and call the doctor for her. Thankfully, that's what happened, and Valtrex was ordered. My mom went and got it for her. Mom said she suggested Mam-ma eat when she took the medicine. She reached in the refrigerator and got out a bowl of some kind of chicken -she said dumplings. Mom suggested that she eat a peanut butter sandwich. She said that was a good idea, and then began mumbling about she hoped she had crackers. And she reached on top of the refrigerator and sat down a box. Mom asked her if she wasn’t going to make a sandwich with bread. “Well, I could,” she said. And she did. Mom suggested that she always take the pill with half a peanut butter sandwich. Besides, that’s some extra protein for her. We will have no clue whether she follows through with that or not.
Tuesday night, Mam-ma called my mom and asked if she could take a whole Ativan - said she was hurting and the Ibuprofen was not doing the trick. Mom called me to consult, and I double-checked the medication list... yes, she could take a whole pill and go to bed.
So this morning, Mom phoned to check on Mam-ma, and the Home Health aide answered and indicated Mam-ma was not feeling well. Then I got a phone call - Mam-ma - and she sounded horrible (and also like she doesn't have her teeth in!), and she asked what I was doing today. I told her lots of things, and I asked what she needed. She said, "Well, I was wondering if you want to come get some okra and tomatoes." I told her no. She indicated she has had this food for a few days and couldn't remember who brought it to her. I told her I could get it Friday when I take her to the beauty shop. She said she would not be going to the beauty shop this week. I told her I would still come and shop for her groceries, and she said, "Okay, I will see you tomorrow." I pointed out that tomorrow is Thursday... not Friday. She said goodbye, but then I noticed it took her nearly a minute to hang up her phone. I'm thinking she may be overmedicated on Ativan - or hung over from taking that extra half tablet.
Meanwhile, we are keeping Timothy on Tuesday and Thursday afternoons while his mother attends her algebra class. He is adorable, and it's the best 2 hours of our day! He sleeps so peacefully, and when he is awake, he talks and laughs and smiles and KICKS! He is pure and unblemished and just plain fun! He is also even more dependent on us than a 97-year-old woman, which puts things in perspective. We are truly "sandwiched" these days... and it's an experience!