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!”

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!

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!

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!

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!

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!

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!