Tag Archives: Doctors

Therapy Pt.lll: The Three “P’s” plus One

Posted in May by

Even though I was perturbed, I’d not yet written off Dr G’s referral (but I was turned off by what I’d learned so far).

Before I dove into the mountain of paperwork required to see the doctor I decided to call back to ask what type of therapy the doctor practiced. When the person answering the phone couldn’t answer what I thought was a perfectly reasonable and simple question I tried to help her by asking, “Does he follow Freud, Yeung? Is he a Behaviorialist?”

You can’t really hear silence but it’s not like she was saying anything so that’s all there was on the other end of the line. When she did speak it was to mispronounce the names of the two long dead fathers of what we now call ‘talk’ therapy.

I went from being frustrated to disturbed that she couldn’t answer me.

But, realizing that she probably wasn’t get paid enough to know more than how to say “Doctor’s office” and “Please hold” I cut her some slack and asked if there was anyone else in the office who could help me.

So, using one of the skills she had at her command she put me on hold for a moment, after which another female voice came on the line and introduced herself as the office manager, understood that I had a question and asked if I could “please repeat the names I’d said earlier.”

“Sure”, I said and parroted my query.

“Fried?” “You who?” was her response and that pretty much told me all I needed to know (if not about the doctor, then about who he surrounds himself with and who he chooses as his representative to the unsuspecting and often unbalanced public).

“Umm,” she stammered, “I’m not familiar with those names she said, “but I think it’s the last person you said.’

“You’re the first person who’s ever asked that question. I’d ask the doctor but he’s in with a patient at the moment.”

“Think!…you think?!” I thought to myself. (Horrified) that she identified a type of thereapy that a doctor practices (behaviorism) for an actual person, I wanted to ask if she was pulling my leg but what I said was, “I think that’s all the information that I need, thank you.”

Setting aside the fact that she was the ‘office manager’ and the one person in the practice who should know the doctor’s credentials and methods I wondered, “Hadn’t she ever seen a Woody Allen movie or any Rom-coms based in New York City?”
They’re filled with therapist humor. Someone is always; either going to a shrink, making fun of shrinks…or is a Shrink.

I clicked off the line knowing that I wouldn’t be clicking on their website, wasting anymore of my time or printer paper anytime soon.

Update: I was later corrected by a clinical psychologist (who just happens to be a dear friend) who told me that the doctor I was referred to (and was asking about) was a “Psychologist and not a “Psychoanalyst” (a disciple of Feud) so I was asking the wrong question.

Okay…my bad, so the “Freud, Yeung, Behaviorist” query didn’t apply….but still?”

Not to absolve myself of my personal responsibility but shouldn’t they have known that I was barking up the wrong type of analyst’s tree?

Fortunately the following link can explain the Three ‘P’s” (The Psychiatrist, Psychologist, and Psychoanalyst) so that you don’t sound like me…the fourth “P”(a ‘Putz’) when you’re shopping for a therapist.

The Psychiatrist, Psychologist, and Psychoanalyst: The Differences Between the Three P’s

Therapy Pt. ll: #CyberPaperTiger

Posted in April by

Our family meeting was on a Saturday so first thing the following Monday morning I was up early researching therapists to make Miss Cathy some appointments. The first call I made was to Dr G, her family doctor, he’s the doctor that’s known her longest and she respects the most.

Just like in business, it’s always smart to network with those that you respect and healthcare is no exception.

These days the instinct is to type ‘Therapist’ into Google but I think it’s best to have a referral (if possible) from a doctor who knows your loved one so that there is (hopefully) a personal connection when they are giving you a therapist’s contact information.

Unfortunately I did not feel ‘connected’ to the therapist Dr G recommended.

The therapists’ office was located nearby which is convenient but unlike in real estate it’s not just about “location, location, location”.

I’d called to set up a consultation with the therapist’s office and almost immediately I was turned off by the receptionist’s Priorities. She seemed to be much more focused with how the practice was going to be paid than with information about a potential new client.

Believe me, I know that the medical field is a business and everybody is out to “get paid” but can’t we at least have a modicum of pretense that it’s about the patient and not “the paper”?

The person that I spoke with also referred me to the practices’ website where “I” was to download, print out and fill out several forms to bring to the first meeting (information regarding payment-first and foremost).

While asking for a dossier (even before one sees a doctor) is quite common these days I just didn’t get a great feeling from the elitism of it all.

What if I didn’t own a computer, printer or have an Internet connection? Isn’t it awfully presumptive of a person’s status on the part of the doctor’s office?

And it’s not like we’re talking about making a ‘Ped’s’ appointment for a child here, this is an appointment for someone that’s almost an octogenarian.

Suppose Miss Cathy was the one calling to set up the consultation, can you imagine her trying to navigate the homepage, ‘clicking’ on links, going from ‘new patients’ to ‘forms’ to…well, you get the picture, besides, I don’t think mom has turned on a computer since she retired from the Veterans’ Administration back in Nineteen hundred and ninety three…enough said.

It just seems to me to be alittle insensitive for someone who supposedly specializes in geriatric counseling to put a 21st century burden on people born in the early part of the 20th century, is he a “Therapist’ or a ‘Cyber Paper Tiger’?

#Therapy Pt. l: Old Dog, New Day, New Way

Posted in April by

One of the revelations that came out of the ‘alz-ervention’ a few weeks ago when the family sat down to talk to Miss Cathy was that she expressed an interest in therapy (I immediately went to the window to see if pigs were flying but it was just the blooms off the Cherry Blossoms).

To say I was surprised, shocked and elated (is true) but mostly I was happy that she was
ready to face some of her demons, many of which have nothing to do with Alzheimer’s but the Alz has definitely ‘heightened’ some of the parts of her personality that are….how shall I put this? …..strong (read: annoying as sh*t) but seem to me to be (deeply) rooted in some pain or past that hopefully she is ready to face.

I’m a big advocate of therapy, it’s helped me immeasurably at different times in my life but I also know that sitting across from a stranger, though a professional they may be, is not for everyone and especially someone Miss Cathy’s age (and generation).

And I know that the ‘Greatest Generation’ is not ‘great’ about ‘sharing their feelings’…especially when it involves the kind of navel gazing that my self absorbed generation (the last of the baby boomers-thus aptly named the ‘Me Generation”) is/was all to eager to explore.

We (me) grew up reading “Jonathan Livingston’s Seagull”, ”How to be Your own Best Friend” and “I’m OK, You’re OK”, while our parents still remember reading the WWll mantra “Loose lips, Sink ships” (and internalized that to inhibit introspection apparently).

But, it was because of their stoicism growing up during the depression and thriving after the war(s) that we were able to run around with feathers and flowers in our hair (be it an afro or parted in the middle and worn as long and straight as you could iron it), drink Coke (and later snort it) and ‘try to teach the world to sing in perfect harmony’.

So, giving the differences of how we learned to cope I applaud an older person, specifically my Miss Cathy for embracing self-reflection.

Who says you can’t teach an old dog new ways to contemplate.

Physician, #HealThyself: Pt.lll Dr G, General Practioner/Family Doctor

Posted in April by

I called Dr G a few days after Miss Cathy’s world wind of ‘white coat’ hopping (from ophthalmologist to neurologist to numerous test) to hear him say that no one had called him regarding her condition (quelle surprise!).

“This is the first I’m hearing of it, tell me what’s going on.”

So, I did.

Dr G is her primary care physician. He’s someone that she’s been seeing for well over 30 years. She is very comfortable with him and he with her; after all of these years they have a sort of shorthand when they get together.

I remember him from years ago when I used to visited mom from where I lived in New York and he still looks the same; old, wise and kind. Come to think of it…if he was ‘old’ then and now, thirty (plus) years later he’s ‘older’ still, the how old is it?

The mind reels.

Anyway, he’s one of the last of a dying breed of doctors that ‘might’ actually make a house call if you were in such a need.

Since I’ve been Miss Cathy’s caregiver he’s on time for our appointments (or damn near close to it) professional and compassionate. He always returns a telephone call and follows through with whatever he says he will do for you.

That’s pretty much the ‘gold standard” of a successful working relationship (in any profession) in my opinion-but when a doctor is part of the equation it’s even more important to know that you can count on them to do what they say they’ll do.

I’m not talking about a doctor becoming your bff and calling every time something funny happens on RuPaul’s DragRace (although lets face it-something funny is always happening on RuPaul’s DragRace).

But, even though we all know that doctors are busy and they have responsibilities WE as caregivers and patients are just as busy and we have a responsibility to our health (or the health of a loved one) and that needs to be respected and reciprocated.

And Dr G does all that.

A good doctor is like a the best waiter in a four star restaurant, you know they have other tables to serve besides yours but somehow they appear when you need them, listen to what you want, bring it to you and make you feel as if you’re the only table in the joint.

And that’s’ what I’m looking for from Miss Cathy’s’ ‘team’….I want to feel like we’re the only table in the joint.

#Physician, “Heal Thyself”: Pt. ll

Posted in April by

As a caregiver I’m responsible for all aspects of my loved one’s care, and as Miss Cathy’s son I feel doubly responsible for her physical and emotional well-being.

To that end I have tried my best to work with doctors’ that she’s had relationships with for years as well as those that are new to both of us since her Alz diagnosis in 2010.

It’s my feeling that at the end of the day she is only as healthy and happy as her ‘team’ of doctors has helped her to be (and that means if it’s a regular check up or when she is in crisis).

My opinion(s) of her ‘team’ (of doctors) shouldn’t matter one way or another (you know what they say about ‘opinions’…) butt, of course I have one (some) and here they are:

Dr S, The Ophthalmologist

After her (seemingly) abrupt loss of vision and increasing confusion, the eye specialist was Miss Cathy’s first request of a physician to ‘see’ and it made sense since ‘suddenly’ she couldn’t.

Miss Cathy has been going to Dr S for years; a birth defect took away the sight in her left eye so she’s been dependent on her right eye her entire life.

We waited almost a week for the appointment because the receptionist said, “that was all they had” and my explanation of her situation didn’t move her to get us in any sooner.

The doctor’s assistant brought us back into a room where she performed some preliminary tests. Dr S came in soon after to take over the exam when it was clear to the assistant that Miss Cathy’s condition was anything but preliminary (and above her pay grade).

He asked her several questions, had her hold a Victorian looking contraption and told him what she could (or could not) see through it, the after some other optical tests he rendered his opinion.

He ruled out a stroke, then he said that he saw no blood behind the eye so he could only conclude that the eye was ‘healthy’ and he seemed just as puzzled as we were that she couldn’t see clearly….literally and figuratively.

When Dr S confessed that her problem might be “outside of his area of expertise” I wasn’t happy that he didn’t have a solution to the problem but I was impressed with his honesty and humility. While I find doctors to be honest I’ve seen more hubris than humility from most.

He suggested that she might need to consult a neuro-opthamalogist to determine if there was a problem between the optic nerve and the brain.

After finishing up my copious note taking I told him that she already had an appointment to see her Neurologist, Dr A next.

He asked who her General Practioner was, recognized the name and said that he would confer with him as well as the Neurologist.

“We’ll take it from there” were his parting words as he offered us his hand but no solution before saying goodbye.

We left his office knowing no more than when we first arrived but after hearing how long it took us to get an appointment Doctor S said that they were upgrading her chart to “priority” (kinda like being bumped unexpectedly to Business Class from Coach).

I walked out feeling as if he was either trying to express some sense of urgency for her condition or that it was just some bullshit gesture for a flight (diagnosis) delayed.

The other #”F” word: Pt lll

Posted in April by

Back in 2010 when it was discovered that Miss Cathy had first stage Dementia with an Alzheimer’s diagnosis, I asked Dr Alemayehu, her neurologist what to expect.

He said something to the effect that “each patient is different and their mental faculties diminish differently at varying rates, some deteriorate rapidly while others can remain relatedly stable for years ”. What I remember most clearly was that he sounded about as matter of fact and dry as if he were talking about actuarial tables.

He couldn’t and wouldn’t give me a timetable for progression of the disease (and rightly so). The control freak and planner in me would just have to sit tight.

As my mother used to say, “You can’t set your clock by crazy”.

It was going to be a game of ‘hurry up and wait” (for what who knew and how much care she’d need was a question mark). There’s not much one can do to prepare except avail oneself of books, support groups, websites, et al so that’s what I’ve been doing.

Then, that day not long ago, the clock chimed ‘Koo-coo” and the alarm bells in my head went off, time to put all that ‘book learnin’ and research’ to use.

The slide downward had begun again and it was obvious that the doctor was right; her disease was just on holiday….much like I was.

It’s not like I thought there was a “sell-by” date on Miss Cathy’s sanity but I couldn’t help but be surprised when the time came and things started to change.

I found that I’d started to live day to day much like the characters in the movie “Groundhog Day”, on a calendar that doesn’t change and if/when it does its only toward a future grounded in the past.

I’ve also realized that caregiving is a marathon and not a sprint.

Unlike a disease where you can have a nice hospital stay where friends and family can come visit to feel better about themselves (in-patient treatment for Alzheimer’s is few and far in between-and are usually the result of a fall or some other by-product of the disease) or get an operation for a cure (there isn’t one) or take a pill to put your illness in remission (it doesn’t exist).

So, it’s not about the ‘quick fix’ because there isn’t one, buying a helium “get well soon” balloon is well intended but not what’s needed to tend to your loved one’s well being.

It’s about living close (or in close proximity) and day to day care, teaching the same things over and over, aiding and guiding your loved one through simple tasks that they’ve performed thousands of times before but now are as foreign to them as you will one day become.

It’s also about being available 24/7 for comforting and empathizing, explaining the same questions and correcting the same mistakes again and again, day after day, after day.

So, Miss Cathy and I are joined, hand in hand, walking through the valley of the shadow of decline.

For her, the loved one, the one with Alzheimer’s, her “F” word may be “Forgetting” and, for me, the caregiver, the one that has chosen this journey my “F” word may be “Frustrating”.

But, at the end of a long day, when your loved one is tucked away, and there is peace and quiet in the home, one might just think of the other “F” word……“Faith”…….faith in the knowledge that tomorrow is a new day, and with your loved one, a new chance wipe the slate clean and to start again.

Postscript: Since this posting Miss Cathy has undergone an MRI (which was non conclusive) and is scheduled or an MRA and a Diabetic Retinopathy while her ‘team’ continues to find an answer for her sudden loss of vision.

#Flareups

Posted in March by

It’s been months since my last communiqué and for that I am sorry.

Simply put there hasn’t been much to post; other than the occasional “flare up” of “Alz” life seemed to have fallen into a predictable, non eventful pattern.

I had a respite from the disease but, life being “life” and “Alz’” being “Alzheimer’s” things were bound to change.

So, I am back, sharing the little things and the not so little things that have happened and that are happening now.

I haven’t been posting but I have been writing so some of what I’ll be sharing has already past so it’s out of time but not out of context.

It is odd and peculiar to this disease (and particularly cruel, I think) that weeks, even months can go by without incident then all of a sudden, as if someone turned “off” a switch, things that were routine and known are all at once foreign and unfamiliar.

Miss Cathy has gone from an occasional state of confusion to living in a place where simple acts; putting her shoes on the correct foot, disarming the security system and operating the television remote have become almost daily challenges.

Things that she’s done for years are now a struggle of some kind, I’ve watched as she seems to approach her routines with trepidation.

At first she made the usual excuses; food being burned (“The meat cooked too fast”) or not being able to operate the telephone (“Something is wrong with this phone, I need to call the telephone company”) and the remote (“I can’t see these numbers, they seem to be moving or something”) to a realization that it could possibly be something else, something more (“There’s something not right with my brain”)….and I agree.

Enough has happened that it’s time to get her ‘team’ (general practitioner, neurologist and even her ophthalmologist) back on board to check her out. Maybe she just needs new glasses, her diabetes could be a factor or her meds need to be adjusted-or a combination of all the above.

No matter, it’s time to send a flare up to signal that the “Alz” has awaken from it’s slumber and it’s time to do battle; time to re-engage, re-learn and chart a new course of action.

I hope to get back to posting regularly and that you will continue to follow me on this journey-

Thank you

Dr Alemayehu Part l

Posted in September by

A Friday morning appointment with Miss Cathy and her neurologist, Dr Alemayehu:

“How has your summer been?” He asked her after we were seated in the examination room.

“Oh fine, fine”, she replied, eager to update him, “it’s been wonderful ever since you said that I could stay at home by myself; gosh, you don’t know what a blessing it’s been not to have to go anywhere when my son goes out-of-town. It feels wonderful so I truly thank you.”

“So”, the doctor said smiling at her, “you’ve declared your independence! Well, that’s very nice, I want you to know that I prayed for you.”

“Did you, oh bless your heart, thank you doctor.”

“Now”, he said suddenly becoming more doctor and less old acquaintance, “ I want to ask you a couple of questions.”

“How do you function? “How is your memory?”

“Well”, she said,” I do alright, but I get nervous.” When he asked what she meant she told him about the earthquake and having to go to the emergency last month because she was so upset over her granddaughter being in the hospital.”

He listened but didn’t comment right away, then he said, “I want you to take this pen and paper and I want you to do something for me but I want you to listen carefully before you start.”

He told her that he wanted her to draw the face of a clock and to put in the numbers where they should be, then put the hands of the clock on 10:45. Satisfied that she understood what he was asking of her he got up from his seat and left the room.

I looked on from my chair in the corner as she drew the circle, then the number “6”, then the “12” and the numbers 1 through 5 down the right side of the clock (pretty good so far) then she put the number “9” almost in the center of the circle and the rest of the numbers were in the right order but they were more or less vertical instead of following the left curve of the circle that represented that side of the clock.

“What time did he say,” I heard her ask herself,” was it 10:45 or 11”45?” Then she looked at me and asked me, “What time did he tell me-11: 45?”

I mimed zipping my lips and she said, “Come on now, hurry up and tell me so we can get out of here.”

“No can do,” I said, “ It’d be like helping you cheat on a test.”

Since she drew a very short hand that went from the middle of the clock to the eleven and another verrry short hand that pointed toward the nine it was hard to tell what time she was trying to indicate. But when she was finished she wrote “11:45” at the top of her page so that her intent wouldn’t be misinterpreted.

Dr Alemayehu came back into the room, sat down in front of her once again and studied her drawing. “Do you think this right?” and when she said she thought it looked like a clock he said, “ I’ve never seen a clock with numbers running up the middle and the time was supposed to be 10:45.”

But he seemed satisfied (enough) with the drawing so he continued with his questions.

“What floor are we on?”

“First”

“”What kind of office is this?”

“Neurology doctor”

“What’s the date?”

“Eight, August, twenty-eleven.”

“Who’s the President?”

“Dr….uhh, Obama.”

“The one before?”

“Oh, I will never forget him-Bush.”

Then he showed her the word “world” written out on a piece of paper and asked her to spell it backwards.

Next week: Part ll

Shake and deflate

Posted in July by

Thursdays seem to be “doctor day” lately, last week we were at the family doctor for a check up and last Thursday, I was waiting with Miss Cathy to see another doctor-only this time it was in an emergency room.

Let me back up a moment and tell you how we got there. Tony called me on Wednesday to tell me that Nile, my niece was in the hospital with a collapsed lung. It was just one of those rare, freaky things that “just happen sometimes” and unfortunately it happened to her. Thank God she was at home taking summer classes and not back at school alone when it happened. I was in shock listening to him tell me about tubes, fluids, punctures, thoracic this ‘n that, trying to make sense of it all. The only thing I could focus on was that he said she was out of danger.

We did the dance of “You don’t have to come, it’s too far” and “Of course I want to be there” two-step that loved ones do with each other when one feels they’ve imposed enough with the news let alone adding to the burden by expecting the other to drop whatever they’re doing to be there and the recipient of the news feels impotent to help but wants to take some kind of action to show they care, even though they know they can’t affect any real change in the situation-so, showing up is usually as good as it gets. The only thing holding me back from leaving right then was the question of what (if anything) to tell Miss Cathy. I told Tony I was going to leave it was up to him and that he should take some time to decide if he wanted to tell her; running the risk of getting her upset by telling her or running the risk of getting her upset later on after the fact-it was pretty much a lose, lose situation.

He decided to call and tell her.

I was in the kitchen making myself some lunch after running errands all morning and taking a yoga class when she came into the kitchen in her nightgown to talk about the news. Her timing couldn’t have been worse because I was already running on fumes so I just couldn’t handle listening to her (not that she didn’t have every right to be upset). I just needed a moment to sit down and digest some food and the news about Nile before I could be any use to her. I felt as if I was being cold or that I was putting her off but I’m learning to take care of myself first (so that I can best be there for her later). It’s kind of like when you’re on an airplane and they instruct you (in case of emergency) to put your oxygen mask on first and then the child’s because you’re no good to them if you’re deprived of air-well, I felt like I needed to put my mask on first.

I could see some disappointment on her face as I told her that I needed just a little time to sit down and eat, then I would come and talk to her about Nile. She acquiesced and went back to her room. Through my open door I could hear her making calls, reaching out to share her pain but no one seemed to be there when she called.

Tony called back to tell me that she seemed to take the news okay and that she didn’t give him any indication to him that she wanted to come to the hospital so I took that as a sign that she might not want to go anywhere. I looked in on her a few times while I was supposedly “taking care of me first” but I couldn’t help it, I just wanted to make sure she was okay. What I saw was that she was restless and she just couldn’t sit still; first she was on the phone (in her nightgown), then when I looked in on her again she was fully clothed, with lipstick and her hat on sitting on the edge of her bed ready to go somewhere, so I asked, ”What’s going on?”

She didn’t answer, she just looked at me. A few minutes later, realizing I wasn’t going to be able to “put my mask on first” I went back into her room but she wasn’t there. I found her sitting on the sofa in the living room (back in her nightgown) looking sad and lost, her hands shaking just a little. Knowing that she’s a very nervous person and upsets easily (even before her diagnosis) I wasn’t surprised but I checked to make sure that she was “just upset” over her granddaughter and not about to have a seizure or a repeat of her disorientation and near collapse of a few weeks ago. I brought in the bowl of soup and toast on a tray that she’d left in the kitchen and sat with her to make sure she didn’t spill anything on herself while she ate, raising the spoon to her mouth with a trembling hand.

After she finished eating I suggested that she lie back down so we walked back into her room and we talked about Nile when she was comfortably under the covers. At the end of our talk she asked, “When do you think we can go to the hospital?” I told her we could go right then, but it would have to be in the next fifteen minutes to beat the impending rush hour traffic on the Beltway. Knowing that she couldn’t get packed and ready in that time frame she agreed that we wait until rush hour was over before making the drive to the Virginia hospital across the Woodrow Wilson Bridge on interstate 95, which is notorious for accidents, delays, construction and traffic congestion (and that’s on a good day). I told her that we should take advantage of the wait by napping because it was probably going to be a long night, so she and I both lay down but neither of us got much of a rest.

Even though she didn’t sleep and was “up” she was very slow getting out of bed. Bt the time she was packed and ready to go it was 8:00pm. As luck would have it, traffic had died down so we were at Mary Washington Hospital in a little over an hour hugging Nile and Tony, Suemi and Zachary, Nile’s brother. They had all been at the hospital since early morning and I could see the concern on their faces, all except Nile, she looked great-considering (and I’m sure the Percoset drip didn’t hurt). With Miss Cathy and me there out little family was complete, Nile being the last addition to the family nineteen years ago. She was remarkably composed and alert, not at all what I expected from someone with a tube sticking out of their side and only one functioning lung. She was sitting up in bed chatting with us, seemingly more concerned for everybody else than herself.

Miss Cathy sat in the chair by the bed holding Nile’s hand as Tony filled us in on her condition, saying that it was still a matter of “wait and see” whether or not surgery was going to be necessary. It was after nine when we got there and we stayed for a few hours, Mary Washington being one of a few hospitals I’d ever been in that had such a liberal policy for visiting patients. But, it was getting late so we ended our visit and drove to Tony’s house, everyone exhausted from the day and anxious to get a little sleep before being back at the hospital in the morning.

By eight am Suemi, Miss Cathy and I were in the kitchen having breakfast; Zachary had to go to work and Tony had decided to take another day off from his job and was already at the hospital. I was sitting in the family room that opened onto the kitchen, Suemi was at the kitchen counter preparing snacks for everyone and Miss Cathy was at the kitchen table with her back to me, talking to her daughter in law. Knowing that she could sit there and talk forever I suggested that she might want to think about getting ready since it would take her awhile and I knew she was anxious to see her granddaughter.

She said, “I think I’ll just sit here and relax for a little while” which I thought was an odd response since all she’d been talking about was getting to the hospital but I shrugged, and decided to fire up my laptop to distract me from overhearing the conversation between the women that I’ve heard many time before. A few moments later I caught something out of the corner of my eye and it was Miss Cathy’s hands that were shaking. I got up to go to her just as the shaking started to take over her body, Suemi saw this happening at the same time and reached her first, cradling mom’s head against her side talking to her soothingly as the shaking became uncontrollably.

No sooner had I reached the sink to get her a glass of water when her eyes started to roll back in her head and she vomited the oatmeal she’d had for breakfast. Suemi said, “Call 911” and I fumbled with their landline, surprised by how quickly the situation had gone from familiar to chaotic, panicking a little myself, before calling the paramedics on my iPhone and regaining my footing. Suemi was brilliant, she was in control and calm and I followed her lead, grateful for once, not be alone to cope with the situation. By the time I’d given the 911 dispatcher the address and told her the situation Miss Cathy had stopped shaking and I could see that she had “come back to herself” (her eyes were newly focused and she was coherent). She seemed out of any immediate danger and said that she didn’t want to go to the hospital but she still wanted the EMS to come. She was understandable upset and started to cry a little, Suemi by her side to comfort her. I knew she was out of danger when she started barking orders that Duke, the dog needed to be put away before the emergency service workers arrived- even with vomit on her nightgown she was still trying to be in control.

We’d cleaned her up as best we could and she was trying to change out of her nightgown into a pair of pants by the time the paramedics arrived (which was under ten minutes). Two paramedics worked on her while a third asked her questions to ascertain her condition and to determine how alert she was. I jumped in when necessary (to correct some misinformation she had given) and I took a mental note that I should always carry my “Mom” notebook (which has all her medical history, prescriptions and all relevant information in it) with me at all times so that I’m better prepared in a situation like this.

When the medic asked her if she wanted to go to the hospital she said “yes” and burst into tears. I went to her this time (Suemi was out in the garage with the dog) and held her close as she sat in the chair crying, saying that she was afraid and embarrassed, her ego de-flated. I told her that I was there, that Suemi was there and nothing was going to harm her. I told her that all the people in the room were there to help her. By this time another team had arrived from an ambulance service and they put her on a gurney and drove her to the local hospital emergency room. I grabbed as much of her stuff as I could and followed in my car, Suemi waving from the open garage door saying she’d be there soon.

We stayed in room 10 of the emergency room for about four hours while they took an EKG and chest x-ray. She’d calmed down considerably and slowly became her usual “Chatty Cathy” self with the nurses. The doctor examined her early on and came back a few hours later with the test results, which confirmed that her episode was anxiety related. Her blood sugar and pressure were understandably elevated so they wanted her to stay for awhile and relax until her levels could stabilize then I could take her home. This would be the third time she was in the emergency room due to a nervous response to a situation; it was obvious that she couldn’t handle stress anymore.

Once we were home I got her comfortably into bed where she napped for the rest of the day. I’d already talked to Suemi in the emergency room about what we needed to do moving forward and later I called Tony at the hospital where he was still waiting to hear from the doctor about Nile’s condition to tell him that Miss Cathy was okay. We all agreed that what happened to mom confirmed what we’d suspected all along. We decided that it was best that we no longer tell her anything that could upset her. She just can’t handle bad news or stressful situations anymore; it’s not good for her health.

While she was resting I washed her soiled clothes, refilled her meds and got back to some our day-to-day routine. Then I lay down for a nap myself and slept like a dead man for four hours, waking up at 7 pm to check in on Miss Cathy and she was sitting up in bed watching television.

Post script: On Saturday afternoon Nile was released from the hospital after her lung had “re-flated” without the need for surgery. Her prognosis is good and she should be able to return to her hectic, active lifestyle as a co-ed in a few weeks, but since this happened to she has a recurrence rate of 30% in her lifetime.

As for Miss Cathy, she woke up on Friday feeling like her old self, “pumped up” as good as new. Her cousin, Mary came to the apartment with her daughter Juanita for a visit and that lifted her spirits but nothing made her happier than finding out on Saturday that Nile was home. I could hear her on the phone talking to Tony offering to come over to “take care” of Nile while she was convalescing-completely oblivious that “she’s” the one in need of care.

Romancing the stone (granite)

Posted in July by

Last Thursday was Miss Cathy’s quarterly visit to her primary care physician, Dr Granite; just a tune-up to kick the tires. As usual she’d been “mentioning” the appointment daily for the last week so when the day finally arrived she was all ready with her list of questions and sitting on the couch ready to go before I’d finished my first cup of coffee. She always gets a little “wound up” (anxious, hyper and nervous) whenever we go to see one of her doctors so I was having second thoughts about something I needed her to do.

My brother, Tony and I have met with a lawyer about setting up her estate and putting things in place so when the times comes and she needs to go to a nursing home that Medicaid will cover the entire cost. We’ve got a lot things going on and part of the process requires a form to filled out by her doctor. I knew I could ask the doctor about it but it might come off as predatory, like I was setting her up to rip her off (and I gotta say-it’s not like she’s Crystal Carrington and this is Dynasty or anything, but still…. ) so I thought it best if she asked for the form since he was her doctor and they have a good rapport.

The form that we need filled out is very subjective and completely voluntary so a lot of doctors don’t want to get involved, so it might require some finesse and tact to get it (and while Miss Cathy has still has many wonderful attributes “finesse” and “tact” are not two of them). But, it’s a pivotal part of what we’re trying to accomplish so it’s important. I took my time and patiently, in as simple a manner as possible told her that we still haven’t gotten anything finalized with the lawyer but it would be great to know if the doctor was even “willing” to help out. All that we needed from him right now was to know that we could count on him at some point in the future.

I stressed that all I needed was for her to ask Dr Granite was for his help at some point in the future with a form that would state her condition and that her son (me) is her primary caretaker-sounds easy enough but the simplest things can be complicated in her present condition. I took great pains to be as specific as possible and prep her on exactly what to ask. To be fair, I was springing all of this on her just an hour before the appointment but I thought better last minute than days earlier when she might forget or get confused.

As expected, she had a ton of questions, and they just kept coming-from the obvious to the inane, I felt like I was being ravaged by a swarm of bees. Patiently (without scratching myself) I tried my best to answer all of them knowing that the more she asked and the more she knew, the more likely it was that she’d get confused. But, all I could do was hope for the best and remember what I’d learned in AA, “take the action and let go of the result”.

As I stood getting ready to leave she looked up at me from the sofa, looking like a little girl lost and said, “I don’t know why but I’m nervous all of sudden.”

I suddenly wondered if I’d put too much pressure on her by asking her to talk to the doctor, or if she felt nervous that she’s say too much or get it wrong. I told her that she didn’t have to worry about talking to the doctor about the form, she could just stick to her list of questions and I would take care of it if that made her feel more comfortable. I started for the door but couldn’t shake the vulnerable look on her face from my mind so I went back to her, gave her a hug and said that I hoped that would help ease her nerves. She smiled back at me and then we were off.

We waited for the doctor in the tiny exam room after the nurse went over Miss Cathy’s vital signs. Dr Granite came in soon after and they fell into their years old pattern of small talk; catching up on each other’s lives with a few laughs and jokes before settling into the business at hand.

When the doctor asked her if she had any questions she made a big production of bringing her crinkled piece of notebook paper out of her handbag and all kibitzing aside she became very business-like and serious as she went down her list asking about her arthritis, the nausea she had a few weeks ago and a “popping’ she felt in her knee. Satisfied with the answers (and most of all his reassurance that everything was fine) I could see her fidgeting a little, winding herself up for the “big” question.

After “hemming” and “haw-ing” a little she said, “Doctor, I want to ask you one more thing..” She started to stammer about “putting her affairs in order” and “a piece of paper the lawyer says she needs” and “wanting her children to be able to do as she instructed” (jeez, it was painful to listen to her but I let her finish because I was the one that asked her to speak to the doctor. And, as wrong as she got it and as exasperated as I was, I couldn’t help but be proud of her for trying).

I could see the doctor trying his best to understand her, his eyes trying to follow her train of thought, like watching a drunk trying to walk a straight line during a sobriety test and all you saw was them weave from point A to point B, still you hoped they’d get to the end somehow. He listened (patient man that he is) and then, seeing an opportunity when she paused (just for a second) he jumped in to venture a guess and said, “You’re talking about a form that states your wishes?” and she said, “Yes, that’s it!”

“You’re talking about a ‘living will”.(No, actually that’s not what she was talking about)

They smiled at each other, very satisfied with themselves that they’d figured out the riddle. He assured her that she didn’t need him to fill out that “form” and any lawyer could supply that document for her. She seemed a little confused but determined because knew she hadn’t succeeded in getting what I’d asked so she tried again to ask for his help but this time I jumped in before she lost him completely (and I had to listen to her struggle to get it right).

I told Dr Granite that we already had an Advanced Medical Directive in place and that’s not what we needed. I said that we (she) were working with a lawyer and putting together her Personal Care Plan and we might need his help filling out a form so that she can get a “Child caregiver exception” to help expedite the rules that Medicaid have set up to be accepted for long term care. He took a moment to digest the information then said, “sure, just bring me the form and I’d be happy to help.”

There was sign on the wall of his office (one that I’d never noticed before) that Miss Cathy had seen when we first walked in that stated that forms and other documents were to be filled out at the doctors discretion and will be billed separately from the patient’s insurance. I told her not to mention the sign but of course she did, she couldn’t help herself.

He shrugged and seemed to dismiss it saying that it’d been there for years (so I took this as a “sign” not to worry about it). Not satisfied (after the doctor had just agreed to help us and had all but told us to not worry about the sign) Miss Cathy just would stop talking about the sign and let the subject drop. Once again, as soon as I found an opening to cut her off (not in a mean or rude way-I just waited for her to take a breath, regardless of whether she had finished her thought or ended her sentence) I reminded her that it was the doctors’ office, hence his rules and to let him finish talking. She acquiesced and he continued, he told us that lately a lot of his patients had been turned down for long term care for one reason or another and that concerned him, but not to worry, he was willing to help in any way that he could.

Miss Cathy thanked him and before she got up go to another room to have some blood drawn as she has had done hundreds of times before she said, “I don’t know why but I’m nervous all of sudden.” And like Blanche Dubois in “A Streetcar named Desire” she innocently took the doctors hand as helped her up out of her seat to prepare for the short walk down a familiar hall.