Can I take my dad to the vet?

In the months that have passed since I last found the time (or maybe the energy) to post a blog a lot has happened.

I've logged hundreds of miles and hours in the car with my trusty side-kick, Jonah. Mostly visiting dad at his home. I've spent a ton of time on my mobile phone between texts and calls with my sisters going over dad's health, medications, appointments and more. The three of us have navigated (not always successfully) the health care and medicare system.

All of this brings us to another stroke.

Several weeks ago, on the day of dad's scheduled eye surgery (another story for another day), my sister Sue arrived early in the morning to take him to his appointment, only to find him waiting in the drive way with uncontrollable shaking and tremors. Off to the ER they go.

13+ hours later, Dad is in a hospital room with a diagnosis of another stroke, only this time it's in the cerebellum.

Well, we're old pros at this now. Through a series of texts and calls, we work out our plan of action of who's going to do what, be where, etc. For the next five days we all put in our time. We get dad back home. Having learned our lesson the last time, we have refused in-patient therapy.

Dad is doing well. However, he is on a whole new regimen of medications. Fantastic.
So we think we've got a handle on all this. All except the coumadin. That's a tough drug. It starts with blood tests every other day. Maybe a whole pill, maybe a half pill. He's not liking taking any of the pills, but one that's going to be a problem just seems to be too much. And it's harder that we all live over 100 miles away and it's not feasible for us to be there constantly (not that it would be good for our mental health).

On a semi- side note, my geriatric greyhound, Yogi (who we've dubbed "The Dog Who Won't Die"),  has renal failure that we discovered after a terrible night with him panting and having trouble walking. Yogi now requires prescription dog food and two additional medications. One for high blood pressure (really?) and one for pain. The vet assured me that Yogi could live several years in renal failure...
Is anyone else hearing this?

So, I don't pay any attention to the meds my dog is on. And even as I type this, I couldn't tell you the name of the blood pressure med. I just know that he gets one every morning. So when we were getting low on pills, I picked up the bottles to a) get the phone number for the vet and b) find the names of the drugs so I can ask for the correct ones.
I do a double take. "Gabapentin." Yep, I read it correctly. My dad and my dog are taking the same medication.
Is anyone else hearing THIS?

Does this mean I can take my dad to the vet? It might be a little cheaper.


All joking aside, the last two weeks has been trying mentally. Dad has become difficult and begins to take pills out of the daily pill box and put them back into their bottles (not the correct bottles, though, so we're on to his deviousness), instead of taking them. Dad thinks that since he feels better, he doesn't have to take all the pills.

I feel as though this is preparing me for having know-it-all teenagers. I don't want know-it-all teenagers.

So it's back to the phone to text back and forth about what to do next.

Why do I feel bad?

Why do I feel bad?
I ask this question, for several reasons. First and foremost, I feel as though I am balancing on a tight rope between the world of the patient and the world of health care workers. After our lessons learned at the hospital, I feel more forceful and adamant to get the best possible care for my father. Yet I am trying to keep my self from stepping on the toes of the health care professionals.
The social worker assigned to my father is difficult to get a hold of. I don't know her office hours, but it seems like I leave a message and then begin the waiting game. She could be the best social worker in the world, but I don't know that. Mainly because I can never seem to get a hold of her.
I speak to her on the phone and she mentions that they may release dad after just 2 weeks in rehab. BUT they want him to go to a nursing home.
We're  not thrilled with that. Dad wants to go home. We want dad to go home.
We push. She tells us that she'll know more after meeting with the doctor, the speech therapist, the physical therapist and the occupational therapist on Thursday.
We're a little rattled. We won't have time to get him the home help he needs in that little time.
She would like to meet with us if possible. Timing is everything and it doesn't seem to be working in our favor. We ask if she could meet us on Sunday. Since my sisters are coming from Virginia and I can't afford to take any more time off work. She agrees.
So we all meet at the rehab center and wait. We're not sure where her office is. None of the doors in the 'social work' hallway have her name on it. It is now after 1pm, the designated meeting time. Nothing. We're pretty much the only ones around.... hanging out.... in the social work hallway.
A woman arrives, is let into an office by the security guard.
We wait a bit more. No one addresses us. Finally, we all peer into the open door and Sue says "Donna?"
It is Donna. Ummm, really? And yet three random women are waiting in the hallway on a Sunday afternoon and you don't think to ask if they are your 1:00 appointment with three women for a Sunday afternoon? Really?
Is anyone else hearing this?

We file in and it becomes increasingly clear that she is not prepared for this meeting. Wow. We are as prepared as we can be, in a situation that we have never been in and are blindly going along hoping for guidance and direction from those who should know what needs done and how to go about doing it.
Yeah, that doesn't happen. The best Donna can give us is that "they" are concerned for his safety and feel he should not go home.
This doesn't sit well with us. Mainly because we know it won't sit well with dad.

Donna hands us a few pages on available assistance for home health / help. It's for Luzerne County. I ask, "Is there a different list for Carbon County? Or does it matter?"
Donna replies that it does matter. I tell her he lives in Carbon County. She then says we'll need different pages. She doesn't make a move to get them for us. Nor does she respond when I ask if she wants the pages she just gave us back.

I want to know why they are concerned for his safety. What is the standard for safe? Is there a number scale the the "pain scale" commonly used in physicians offices? Like, in order to be considered safe you have to be at a level '7' and dad is only at a level 4? She doesn't answer. I ask again. She avoids answering again.
I'm getting irate.
If it were a cartoon, you would be able to see the blood rising in my face like a thermometer.
I try to remain calm. Yet, I still feel bad that I'm pushing so much.

Needless to really say, but we don't get very far.
The only positive we get out of the meeting is that we get dad moved to a different section of the rehab facility. He is being moved to 'elder care'. We hope this will give him a bit more freedom to move around and help him get the 'ok' to go home right from the rehab center. Correction: We PRAY that this is the move we need.
Plus it buys us a week or two more to get our stuff in order and make his transition home easier on our schedules.
We're getting the hang of this whole deal. Plus, we find out that once dad is moved to the Senior Care section, he'll get a new social worker....

Perfect

If this photo could speak, it would tell you about a perfect day.   Almost as perfect as the photo itself.    It would tell you about an unusually warm day in October, 2011.    It would tell you how my boys and I visited my dad for the day.    It would tell you about a leisurely walk we took from dad's house to the lake and all the 'exploring' the boys and I did along the way.      It would tell you how we sat on the bench and chatted about the uncharacteristic weather we had and how perfect the lake looked in all its autumn splendor.    Perfect enough to capture in a photo.  This photo would tell you how incredibly normal everything in life was. And life was beautiful.

And just like the smooth glass lake surface in the photo is calm, so was this point in time. Calm. 

I know now that it was the calm before the storm. A quiet, seemingly innocuous storm that crept up slowly, without a warning bell or siren. A storm that has many parts.

Each part by itself can be handled with ease, but is overwhelming when combined. The Perfect Storm.

We recently had a perfect storm - weather wise. It rained. Then then temperature dropped. There was sleet. Then snow. It was still October, so the leaves still clung to the trees. The sleet and snow pulled down on the branches. Branches gave in and snapped. Power lines came down. Between 6 and 10 inches of snow in the area on already wet, leaf covered areas. Many without power for several days. Individually these things wouldn't be so daunting, but together they made the Perfect Storm.

We are now realizing the perfect storm that is my father's predicament. Years of unchecked health issues. A deteriorating mind. And finally a stroke.

Any one of these issues individually can be handled. Maybe even easily. But when all three came to a head at once, it became overwhelming.

As a family, I think we are all happy that dad was in the hospital for a bit because they were able to discover long term problems that went un-checked and go about fixing those problems. I think I can speak for everyone when I say the stay in the hospital was too long and aggravated an already trying situation.

Having an MRI of his brain we can see the shrinkage that was already in place prior to the stroke. We have slowly witnessed the decline in dad's memory, but dismissed a lot of it. Perhaps even the shuffling of his feet we just chalked up to old age.

Now that dad is in rehab things look a little brighter, or maybe just a little more clear. The future is still uncertain.

Dad is strong. But unbalanced. Trusts no one, but will have to rely on everyone.

Life is testing me and my sisters. Dad has always clung to the rational, and while we've watched his ability to reason decline slightly over the years, it is very trying to reason with someone who's brain is broken. And it is very difficult to remember that his brain isn't 'firing on all cylanders' and have some compassion in those moments.

Friday I left dad after having an argument regarding his situation. I was hot. And it was so hard trying to find that compassion. It began with him wanting me to help him get out of the wheel chair. He got mad when I refused to help. I told him to call a nurse, that he had to follow the rules if he wanted to get out of rehab. I felt like I was speaking to a child, and I think that made him even angrier. I was glad when the physician in the room backed me up, but it didn't make me feel better. I knew I was in the 'right', but winning the argument didn't really feel like winning. It was disheartening. Perfectly disheartening.

We're a long way from that perfect October afternoon. I hope that we're on the right track for a perfect recovery, but that is yet to be seen.

 

"Funny the way it is..."

The more frequently I listen to the Dave Matthew's Band song Funny the Way It Is, the more I'm convinced that it is their version of Alanis Morisette's Isn't It Ironic. Maybe I'm getting it all wrong. But we'll get to that later.

It is November 1st and my trusty sidekick and I are once again traversing to the North. We pass through Reading and I am again chuckling at one of the election signs I see. Someone named Barnhardt is running for Commissioner. If you are a fan of Janet Evanovich's Stephanie Plum novels, you'll recognize the name. I'm sure there's no relation. And I'm sure that this Barnhardt is a perfectly pleasant person. But I just can't pass the big sign without chuckling as I conjure up a vision of the character Joyce Barnhardt and visualizing her running for any type of office.

We're about one hour into our trip when my phone rings. It's a number from the hospital. I answer quickly and Frank tells me that they are ready to move dad to rehab.
I am instantly excited. They are planning on moving him at 4pm, about the time I'll arrive.
I hang up the phone and say a prayer that dad doesn't do something in the next hour and a half to screw things up!
I suddenly can't drive fast enough and the traffic around me is instantly stupid and irritating... funny how it is, huh?
While I'm indifferent about the camera I'm sure is following me, I'm hoping the cops are not watching.

We arrive at the hospital at 3:45. And Jonah has wet pants. Really? And, of course, there are no child pants to be found in the car. Seriously?
So we were that family. A child in diapers, socks, shoes and a winter coat.
Hello? Is anyone else seeing this?
Oh right, everyone we pass by is.
And I think, oh well, my kid may be dressed inappropriately, but at least we're not the ones blatantly disobeying the the "Non-Smoking" signage that is everywhere on this health care campus.

We get to dad and sweep in. I'm bubbling over, I'm so happy today is the day. Dad seems a bit indifferent. This concerns me a bit. Why isn't he happier to be getting out of there?
I check with Frank to see what the plan is. He tells me that transport will arrive about 4:30 to take dad and that we should call a nurse to help get him dressed.
I thank him for his help, return to dad's room and hit the call button.
Dad doesn't want to wait. I help him put on socks. I get out the bag of clothes from the closet. He works on his shirt.
Twenty minutes pass...no nurse.
The transport team arrives. Dad is halfway there. Still no pants on.
Still no nurse.
"Hello? Is anyone else seeing this?"
Finally I flag down a nurse and she helps dad into his pants and coat.
The transport team gets him situated and we are on our way!

We meet up again in the elevator at the rehab center.
"Hey, long time, no see, dad!"

We get dad set up in the brain injury ward. There are several women there fawning over him to help him get settled. Almost instantly the accent questions begin. "Oh, I love your accent, where are you from."
I chuckle at the look on his face. I think he's getting tired of answering the question.
Once they get a dinner tray for him, Jonah and I head to his house to pick up his suitcase (and pants for Jonah).
When we return, dad seems content. We poke through his suitcase together to see what's what.
Jonah hands him the package of cookies we picked up for him. Everything is going well.

One of the women mentions that they have a 'sitter' assigned to dad -WHAT?
"Hello? Is anyone else hearing this?"
A sitter? My brain is overrun with thoughts. Are they serious? A sitter? You mean like someone who sits next to him to make sure he's okay and doesn't hurt himself? REALLY? As in the same thing that at the hospital delayed him from going to rehab? You mean that kind of 'sitter'?
"Funny the way it is.... Isn't it Ironic?"
The woman continues on to say that she doesn't think he needs one, because he seems fine to her.
Yes, at the moment, dad is lucid and friendly. That could change in an instant.

We tell dad goodnight and head back to his house for the night and promise to be by at lunch time to check on things.

*******

Wednesday morning comes and Jonah and I set out to accomplish a lengthy list of things... phone calls, errands and back to rehab by 11am.
After circling Wilkes-Barre (several times, I think), we finally have all the we started out for and head to rehab.

When dad is wheeled into the room, he looks tired. It's time for lunch. It doesn't look horrible.
Dad tells me he could do all the things they're asking, on one foot. I tell him, " Good! Do it! Show them how it's done!"

The sitter that brought dad in tells me she doesn't think he needs one. I tell her that his demeanor and understanding can change quickly, and until he's been here a few days, it's probably best to hang around.

Dad finished lunch, they prepare for his IV antibiotics and he lays down for a nap. I guess this rehab business is tiring.... you know, doing all the stuff they ask... on one foot.

The sun shines a little brighter on our drive home.

Hail Mary!

While the days (weeks) seem to march forward with no sign of stopping, and the fall foliage sneaks it's way down to the lower latitudes, we are definitely hitting autumn with full force. Halloween arrives quickly.

More quickly than I would like. I had not yet finished the costumes for the boys. And then my sewing machine craps out... oy. I'm no seamstress. I fudge my way through the sewing world by trial and error. I have a nice Singer sewing machine that has lots of bells and whistles. The bells and whistles don't always cooperate, but hey, why should my sewing machine be any different than my life?
So at 9:30 on a Friday night, I head to Walmart to find a quick <cheap> replacement.
And it's on... I'm sewing and hot-gluing my way to a costume for my three year old in no time.
Ha! Take that, hidden cameras!

Even Mother Nature seems to think a nice 'trick' for Halloween would be to douse the Northeast with snow. And not just a smattering of frost, but full on snow. Several inches of heavy, sloppy snow. Snow that grinds us to a halt. Interrupts Halloween parties (have they ever cancelled a Halloween party for snow before?), delays my drive to the hospital, and all around, seems out of place.

I kinda feel bad. I can only imagine how confusing the snow must be to dad. It was barely autumn when he was admitted to the hospital. Now, with a very early snow and what seems like forever already gone by, I can imagine how he may think that he's never going to leave there.
I make the trek to the hospital with my trusty side-kick, Jonah on a Sunday afternoon. We make good time for all the 'winter storm carnage' we see on the sides of the road.

We arrive and I see that dad has a new roommate. I'm hesitant to ask what happened to the old roommate. But regardless, this quiet, new man is a welcome change from Mr. Bedpan.
Dad slightly brightens when we enter the room, but it doesn't last long. He makes it pretty clear that he doesn't really want me there. I chuckle inside when he tells me to go and send my sister Lisa up.
I've only been in the room ten minutes and he's tired of me...
Dad is not in the best of spirits and he's confused. He speaks like he's in his home, or like a home that we all lived in at one time. I tell him that Lisa is at home in Virginia, and she won't be up for a while.
We go back and forth and I think we end up just nodding at each other like we are both trying to shut the other up.
Well, good, bad or indifferent, we settle in for the rest of the afternoon. We chat. Dad lectures. Tries to tell me what the saying: You can't teach an old dog new tricks really means.
"Hello? Is anyone else hearing this?"

The nurse comes in to set up a new IV antibiotic. The IV is in a bad place (darn those crappy veins for not cooperating!). So when dinner comes, dad is having issues eating because bending his right arm causes the IV alarm to go off. And he has no real desire to eat anyway because he doesn't like ravioli's. I offer to get him something else. He declines.

So we sit and relax.
"Mary!....Mary!...Mary!....Mary!....Mary!....Mary!....Mary!"
Seriously? The woman in the room across the hall is insistent that "Mary" come to her bed side.
"Mary!....Mary!...Mary!....Mary!....Mary!....Mary!....Mary!"

"Hello? Is anyone else hearing this?"
No really, is anyone else hearing this? I'm half irritated at the annoyance of this woman, but more irritated that nobody is going in to calm her.
Finally, I hear someone tell her that she's not at home and Mary isn't coming right now.
Silence.
"Help me!....Help me!.... Help me, please!.... Help me!.... Help me, please!..."

Oh good grief.

We get dad comfortable and say good night. We're headed to his house. I'm anticipating some shoveling in the driveway, and am pleasantly surprised that only the deck and stairs need cleared.
We get ourselves settled after a run to the grocery store and re-fuel for the next day.

*****

Monday morning finds dad in an okay mood. We brought him McDonald's coffee, that helps. Regardless, he's ready to dole out parenting advice. I find his advice more humorous than irritating. Whatever.
We speak to nurses, doctors, whoever walks in the door. Trying to find out all we can. One nurse informs me that they are going to insert a PICC line. She explains what it is and why it's needed. She leaves. I tell dad what's going to happen, and asks if he understands. He says he does. I ask if he's 'okay' with it. He says yes.
It seems like the PICC team arrives quickly...I'm caught off guard. They need a sterile room, so my sidekick and I will have to leave. Dad tells us not to come back. Ha! Fat chance. We'll be back because all our stuff is sitting around.
We hang in the cafeteria. We see some cute costumes. Then head back up.
The PICC team is done. And dad's demeanor has changed. He is completely pleasant. He even teases and plays with Jonah. It's almost a shame that we have to head home for trick or treat!
 Dad thanks me over and over as we prepare to leave. I wonder what the did to him when they inserted the PICC line, did they give him some "nice" drugs, too? Eh, I'll take it.

And so begins the journey home...

"Tomorrow, Tomorrow, I Love Ya, Tomorrow..."

"You're always a day away"

And so is rehab.

I don't know what to think any more. Way back last Wednesday, I sat with dad and the Nurse Care Manager came into the room to tell us that due to the catheter that dad had, rehab at "Center A"was not an option. She pushed for "Center B". They had a bed. Yippee!

Now, a week later, and still no closer to rehab than the day he was brought to the hospital, we are told by a second Nurse Care Manager that "Center B" would not take dad with a catheter and "Center A" would take him and would be well equipped to handle his urinary issues.
Great! When do we go? We have the suitcase packed. Just give us the word.


No, really... give us the word.

please?

It is one issue after another. Catheter in. Catheter out. In. Out.
Nurse puts in, dad pulls it out.
He's not a good patient. Maybe the rehab centers heard about him. Maybe they don't want him and are stalling until we give up, hoping we find some other un-suspecting rehab center.

Dad is going in and out of his senses. A friend tells me this is typical for stroke / elderly patients. So dad is not in the hospital because he's crazy, he's crazy because he's in the hospital.

I come to the conclusion that things are not going to get better until he gets out of the hospital and into rehab. But he can't go to rehab until things get better.

"Hello? Is anyone else hearing this?"

I'm also coming to the conclusion that the person/people behind the camera that is following me is at times twisted... getting some sort of satisfaction out of prolonging this whole ordeal.

It is again Wednesday and Sue takes over for Lisa.
And things get much worse. Dad now has a fever, is shaking, projectile vomit (oooh, I am SO glad I'm not there today), and pretty much out of his mind.
I'm guessing no rehab today. Just a shot in the dark there.

Blood cultures will take three days... eh no biggie... we're really losing hope on the whole rehab thing anyway.

I wonder if the hospital would  mind if we painted dad's room a different color. Perhaps a more cheery color? I mean, it is a bit drab. And if he's going to be there a while, it would be nice to spruce it up. I'm thinking some window treatments might do the trick?

Okay, so that's probably not an option.

So instead we'll just wait for tomorrow -

Annie started out this one... I think she'll help me close it out...

"When I'm stuck in a day that's gray, and lonely,
I just stick out my chin and grin, and say,
Oh
The sun'll come out tomorrow
So ya gotta hang on 'til tomorrow, come what may"

Disappointment Begat Disappointment

Hope (and perhaps that pesky camera I swear is following me) is sometimes the only thing moving me forward. Without it (them), it would be hard not to just stand still... or better yet, stay in bed with the covers pulled over my head.

While Wednesday was full of disappointment, we all were holding out with hope that Thursday would bring terrific news and all would be moving forward in a positive direction with dad going to rehab.

Hope screwed us...

Wednesday into Thursday brought some definite set backs and with it, disappointment.

Dad woke up at some point in the night, and through some events we're unclear on, forgot about the catheter that was still in and when staff tried to help, he kicked one. Hard enough to send them to the ER.
And while part of me is kinda proud - dad still has some fight in him; and thrilled - to hear that he has some strength; I'm disappointed that it happened.
Because now we're into more set-backs.... apparently assaulting staff members leads to sedation and restraints. And apparently, rehab centers don't like those two things. I'm not sure why...

So while things are improving, dad sits and waits.
Sue's husband left in the wee hours of the morning to sit with dad...and make sure he didn't assault any one else. However, the sedation and restraints were kind of a guarantee that all staff members were safe. Regardless, it was good to have him there.
Sue drove up again in hopes that Friday would be the day. But Friday was just as disappointing.

If I were the hospital, I'd want to get rid of this patient pronto. I mean, he beat up one their employees. And yet, they are hanging on to him. Dragging their feet. Or so that's how it seems.

The family and I drive up Saturday afternoon. We head right to the hospital to give Sue a break. Not much of a break, really. We don't spend too much time before making an exit to allow privacy for bathroom usage. On one hand, I'm kinda tired of looking at these hallways, but on the other hand, the non-patient hallway is completely vacant, and it makes a nice raceway for the boys.

We check back. No movement, so we take a walk. We return only to have just missed the doctor.
Really? The ghost in the night doctor...the one we've all heard about, but have yet to see with our own eyes? And we've missed him because of poop? Really?
Okay, I exaggerate, but not by much.
I rush to the nurse's station to see if he might come back and speak to us so we know what's going on.
He does. And in his opinion, dad is ready to go to rehab. He wants him to go to rehab. But nothing moves on a weekend.
sigh.

We return to the "raceway". Sue returns and we fill her in with what little we know.

I have my lap top and I think I'll entertain dad with some pictures. We never get to it. There is too much going on in the room. And then dinner arrives. We herd the children out and head to the lobby.

We then head out for dinner. My trusty phone leads us to Red Robin where we enjoy a tasty beverage (or two). I don't want to talk about dad... I don't think any of us want to. It is nice to catch up with Sue. We never get to hang out. I suppose that's what happens when you live 4 hours apart.

The family and I head to dad's house to 'camp' for the night. We roll in and it is chilly. Inside and out.
Yeah, it would silly to have heat left on... I mean who trusts those silly thermostat thingamabobs anyway.
"Hello? Is anyone else seeing this?"
We set to work, figuring out the complexity of dad's heating set up and try to warm up the house.  We unload all our gear and head out to the store...I forgot towels. And dad really only has the beach towels from 20+ years ago. I know there are hidden cameras... I'm sure of it.
Actually, everything in the house is like going back in time to my childhood. The sheets on his bed are a mis-matched set that used to go on our little twin beds. I loved that daffodil printed sheet. I don't recall there being a fitted sheet to match, but I loved it none the less.
And the hand towel in the bathroom reminds me of our home in Upper Darby. It is so ugly, yet so comforting.
We play games, we make jiffy pop, we watch a movie. And settle in for our "camp out".

In the morning, we clean up. We rake leaves, mulch leaves, blow leaves, mow leaves... even bag leaves. Just for fun we even filled a couple of those jack-o-lantern bags...the boys love it. I'm pretty sure dad will hate it. But I do it anyway. Take that, hidden cameras!
There is still a giant pile of leaves. Noah is having a blast jumping into it... I figure, why not? And I go for it... Noah loves that I do.
"Hey, hidden cameras! Did you get that one on film? No worries... I'll do it again! Woo hoo!!!!"

We wrap up all that we can do in the yard, set the trash out. Jonah is melting down. I'm growing weary. Noah is a dirty mess. This is fun, right?

We head back to the hospital. Jonah is out cold. So Dan relaxes while Noah and I head in to see dad. Dad is out cold. So we sit.
Dad looks old. Really old.
Noah and I sit and chat while dad sleeps. When dad finally rouses, it's as though he'd rather us not be there. He's tired.

"Bedpan!"
sheesh.
"I need a bedpan!"
Every time I'm in the room, dad's roommate calls for a bedpan. I'm beginning to get a complex.

We decide to head out. Dad is tired (I'm assuming from the non-stop party that is a hospital after hours), and we need to get home and attend to our lives.
It's been a disappointing week/ weekend. We're all weary, but there's always hope.

And there's always tomorrow for rehab... right?