Tag Archives: Life

Dr Alemayehu Part ll

Posted in September by

Continuing with his exam, Dr Alemayehu asked Miss Cathy to spell “world” backwards.

“D, W,R,L….no, that’s not right.” Then she started over again.” D, L, R, R, O,W”

Nodding at her effort (but still making no judgment or comment) he said, “read these words for me” and then he had her repeat “apple, book and key” three times out loud before asking her to move from her chair to the examination table so that he could have a better look at her and administer a series of quick “hands on” tests that lasted about five minutes.

He had her open and close her eyes, follow his pen with her eyes only, tap her fingers then grip his hands firmly with hers and squeeze. After one of these texts he put his pen/pointer back in the breast pocket of his doctor’s jacket and asked.

“Do you remember the three things I had you repeat to me?”

“Yes,” she said, pondered, then started to recite,” Apple….uhhh, gosh, I had it right a the tip of my…..apple and key.”

Miss Cathy tried a couple of times to remember the third item, looking up and around the room as if it were somewhere to be seen, a visual clue somewhere in the small sterile exam room. Finding nothing to help here (and knowing that I’d be of no use) exasperated, she gave up.

After writing some notes in her file the doctor looked at her and reported, ”I’m very pleased with where you are, you remembered two out of three things. That’s very good.”

Hearing this unexpected praise she sat on the exam table, legs dangling in the air like a child sitting on a dock on a summer day who’s just received a Popsicle.

He told her that she could get down from the exam table and once they were reseated in their chairs the doctor asked if she had any questions for him.

Yes doctor I do, “Will the Aricept improve my memory?” she asked.

“No”, he answered, “it keeps your memory ‘where it is.” He went on to tell her that the Aricept buys a patient time because it manages to keep a person from progressing any further in the disease (for a while anyway, until it doesn’t work anymore) but the doctors have no way of knowing how long that will be.

“Will I be able to determine when my memory is failing me?” she asked.

“It’s a gradual process”, he explained, “and I cannot give you a time frame. But, I was concerned about your memory and after seeing you today I can tell you are in the same place you were when you came to see me last. So, your memory so functioning well.”

“Drawing the clock is abstract thinking, which is difficult but you did very well except for putting the numbers in the middle of the clock.”

“I’m very pleased with how well you’re doing so why don’t you come back to see me in six months.”

I helped Miss Cathy gather up her things and drove her back home where she couldn’t wait to get on the phone to call and tell all about her “glowing” report from the doctor.

Who could blame her for being ecstatic, a year ago we sat with the doctor at the beginning of her diagnosis and were full of questions and uncertainty. Six months after that we (all, as a family) had made adjustments in lifestyles and expectations as to what the future could hold.

And now we are in this holding pattern, a “grace period” if you will, life settling into the new normal with no idea when change will occur of how it will manifest. Until that day, Miss Cathy and I will just take it one day at a time and before you know it, another six months will have passed and we’ll be back sitting with the neurologist again.

Hopefully, she’ll be drawing clocks just as well and remembering just as much.

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

I’m Okay, You Okay? Part ll

Posted in September by

I was on my way out the door but feeling uneasy about leaving Miss Cathy by herself, even thought the earthquake had long since passed. I had my metro card in one hand and the other reaching for the doorknob. I knew I’d heard what I wanted so that I wouldn’t feel guilty but I also knew that my gut was telling me something else and I’ve learned (after so many times of not listening) that “gut” trumps whatever I’m thinking so I said, “You know what, I’m not going to work, I’m going to stay here with you.”

Although she said she’d be “fine”, I could see that Miss Cathy was visibly calmer.

I put my shoulder bag down and went to call my boss only to discover that my cell wouldn’t call out (still not realizing the extent of the damage done by the quake). But I realized that I could still text so I sent him a message, changed clothes and joined Miss Cathy on the sofa to watch the news coverage.

We sat watching the television as the full scope of what occurred unfolded before our eyes; there was no loss of life (yet reported) but the quake was felt from the Carolinas up to New Hampshire with varying degrees of impact depending on where you were. Every federal building in Washington DC (where I was headed) was evacuated and most businesses shut down for the rest of the day. The metro (which I would probably have been riding into the city) was slowed down to 15 miles an hour so they could check all tracks for damage. I listened as the newscasters did there best to report the news “ live” without the teleprompters to give them the cool, impersonal polish they usually have during regular broadcasts.

I text’d family and friends asking how they were (if they were on the East coast) and to let them know that we were okay.

One of the reporters commented that we’re lucky to be living in a time when technology has advanced to a place where even if land lines were down and you couldn’t get a strong enough signal on a cell phone to call, one still has the ability to communicate via text. To illustrate his point the camera pulled back and you could see most people on the streets were busy texting on their cell phones.

The same was not definitely not true of the earthquake in I experienced in Manhattan in the early 1980’s or even ten years ago when I was still living in New York City on 9/11. I don’t think I had the ability to text on my phone that day or if I did it was so new (to me anyway) that I didn’t know ‘how’ to text. No matter, the events of that day are buried deep, no need to dredge them up now, suffice to say, I don’t think texting was as prevalent as it is now.

I sat next to Miss Cathy wondering, “what was I thinking?” to even debate whether or not to leave her alone. I was disappointed in myself that my first (and only) response wasn’t to stay and support her. And (during the quake itself) when my first instinct was to make sure my IMac didn’t topple over (granted I was standing right in front of it) instead of immediately rushing out to take care of Miss Cathy, I had to wonder (again) if I’m seriously cut out for this job.

I’m like that overwhelmed parent that leaves the baby in the car seat “on top” of the car and starts to drive away before realizing that ‘something is missing’ AND then remembering his primary obligation and purpose.

I hope whoever is keeping score won’t deduct too many points from me for that day.

I turned and asked how she was doing and she said, “I was heading into the bedroom to take a nap when it happened but I’m wide awake now.”

“I guess that earthquake fixed you for sleep”, I said smiling.

Miss Cathy said that ‘if’ it happened again she would go downstairs to a neighbors apartment. I told her that the best place to be if an earthquake ever happened again (and I’m not around) is to move away from all windows, especially the sliding glass doors, and stand under a doorframe in the back of the apartment.

I held her hand and made her promise she wouldn’t go outside the apartment and risk falling down the stairs. I told he that her balance isn’t good on her best day and in a panic with the ground moving it was a recipe for disaster.

She promised she would heed my advice (but she also promised to stop talking on the telephone in the living room while she was cooking) so I knew to take any pledge she made with a grain of panic.

The phones were back in service an hour or so later so mom jumped on the horn to call family and friends, expelling some of her nervous energy.

I took the time to go back to my room to do the same. The news reports said that the last earthquake to hit anywhere near Washington, DC was more than 100 years ago-an amazing little factoid.

Less than a week later most of the East coast was battened down bracing for Hurricane Irene. Again, we were spared any major damage by the time it hit our area as Irene had been downgraded to a tropical storm but holy moly-that’s a lot of Mother Nature for one week!

Since there had been so much coverage on the weather channel about the impending hurricane Miss Cathy was mentally fully prepared. She wasn’t nervous at all, just concerned as she watched the coverage.
Hurricanes and earthquakes can be traumatic for the most stalwart of us, making it all the more difficult for anyone with cognitive and/or behavioral issues. Special attention must be paid during and after to keep them calm and to explain the unexpected in a manner that is reassuring to them in a way that they can understand.

The experience taught me that like other aspects of our life living with Alzheimer’s that have had to be adjusted, it’s best to be prepared in the event of a natural disaster and I found some great tips on the Alz.org website at: http://www.alz.org/nca/

So, thanks to what I’ve learned I’m okay. Do yourself a favor, learn what you can do so that you’ll be okay, too.

I’m okay, You Okay? Part l

Posted in August by

Standing in my bedroom I could sense “something” coming before I could see or feel it. I guess it’s kinda like the intuition that animals have before something bad in nature occurs, only I’m not feral enough to know what it means or when you’re suppose to run.

Before I could make sense of what was happening the room started shaking and everything around me was moving; the walls, the floor, all vibrating as if it were an everyday occurrence and it was the room’s time to come alive. A lamp on a bookshelf across from me started to fall and I knew that I couldn’t reach it in time but I instinctively reached out to steady the things nearest me as I watched the lamp tumble and bounce for a second or two as the floor moved beneath me.

I stood there, staring at the lamp; the shade crooked, at an odd angle, like it was a person who’s neck had been broken in a fall. Suddenly, pulled out of my dark reverie, I remembered that there was something more important than the lamp or the objects I was holding so I started down the hall to find Miss Cathy.

In the few seconds it took to reach her in the dining room all was calm. I could see that she was visibly shaking as she asked, “What was that?”

“It was an earthquake”, I said plainly, her reaction clearly that of someone who didn’t quite believe what she’d just heard.

I couldn’t blame her really; it’s not the first thing you’d think would be happening, this wasn’t Los Angeles or San Francisco, we were on the East coast, very close to Washington DC where we only read about such occurrences. The only reason I knew with any certainty was because I had experienced an earthquake before. It happened in New York City in the early ‘80’s when I lived on the fifth floor of a six-story apartment building in the East Village.

It was the middle of the night and I remember waking up to what sounded like a loud crash, I thought a semi or some other large vehicle had slammed into the side of our building, that would “explain” the noise but then the entire apartment started to shake. I held onto the bed for dear life not knowing how to process what I was seeing and feeling.

It ended almost as soon as it started but those seconds felt like hours while it was going on, after the vibrations and sound of things falling and shifting there was an eerie quiet that (to me) rang in my ears as loud as the quake itself. There was no major damage from that quake but it was recorded at 5.0 and something that hadn’t happened in New York in more than a century.

Although I didn’t know the official number for our area (yet) it definitely felt a lot milder than what I’ve experienced before. But, being as it was mom’s first quake it didn’t matter if it registered as 1.0 or 10.0-it was just as upsetting.

My instincts told me that the worse was over so I got Miss Cathy settled on the sofa and I walked back through the condo to check to see if there was any damage. I “right-ed” pictures that were askew and picked up objects that had toppled over.

I received a text from my ex, Chad asking “U ok?” and I text’d back, ”I’m ok, u ok” not knowing if he-in the Midwest (or the entire country for that matter) had just experienced the same thing. He’d contacted me so soon after it happened here that I just assumed the same thing was happening to him (later he told me that he was in his car when the news came on the radio so he text’d me right away concerned about Miss Cathy and me).

I rejoined mom in the living room and watched the TV with her. The news reporter announced that a earthquake had just hit a majority of the East coast, registering 5.9 at the epicenter in Mineral, Virginia, about 80 miles away from where we lived. Miss Cathy (now convinced) sat in amazement, digesting what she was hearing and seeing.

“I thought something was going on upstairs in Ron’s apartment.” she said, “I heard this rumpling sound and I looked up at the ceiling fan and I thought it was odd that it was shaking so I thought he fell or dropped something heavy up there to make it move like that.”

She tried calling his apartment but the phone wasn’t working.

Looking out the sliding glass doors that lead to the balcony I could see that neighbors from the apartment complex across the parking lot were streaming outside, coming together as people seem to do when a common experience occurs, huddled together trying to make sense of what had just happened.

“I’m just so nervous, I can’t stop shaking.” She said, “ I didn’t know what in the world was happening, how did you know it was an earthquake?”

I reminded her of my long ago experience in New York and how it’s such a strange feeling that once it’s happened you never forget it.

She seemed to be handling it all pretty well, I thought. I was concerned about her shaking but I wondered if that wasn’t adrenaline-you know, the whole “fight or flight” feeling that takes over our bodies when situations are “heightened” (as this was pretty “high” on the list of things that had happened to her lately).

I asked her if she wanted a glass of water and sat with her after she declined the offer. Given how she’d reacted to recent doctors’ appointments and other mood swings, I have to say (other than the shaking) she was calmer than I thought she’d be but I was no less worried about her. There wasn’t much I could do for her besides sitting with her but sometimes that’s enough.

I had been getting ready to go to work when the quake hit so I got up go back into my room to finish getting dressed. I asked Miss Cathy if she was all right and if she wanted me to stay with her.

“No, I’ll be alright,” she said, “I’ll get myself together after a little while. That’s not going to happen again is it?”

“No,” I said, “probably not, but there are usually aftershocks can come after the initial quake but they’re usually much milder.”

I could see that little factoid didn’t give her much comfort but I had to finish getting dressed and I kept reminding myself that she said she’d be “alright” (I kept repeating this assertion to myself to assuage any guilt I was feeling about leaving her alone).

I must have asked her “are you sure you’ll be alright, I don’t have to go to work, I can stay here with you” half a dozen times. Each query seemed to receive the same tepid “I’ll be fine.”

I picked up my bag and headed for the door going over my rationalizations for leaving
(against a gnawing in my gut that I should stay), using “I’ll be fine” as the green light to go.

It’s interesting isn’t it how we ask a question not wanting an answer so much as permission to do whatever it is that we know we shouldn’t but we’re not quite ready to take ownership of the action, instead, “asking” absolves us of any responsibility for that which we know we shouldn’t do.

Next week “I’m okay, You Okay?” Part ll

Paper Chase Part l

Posted in July by

My brother and I have started the process of getting Miss Cathy’s “Estate” in order. We also want to sure that when the time comes she’s able to take full advantage of Medicaid for long-term care in a nursing home.

The process is daunting; hiring a lawyer (good luck setting all of this up on your own), researching what to ask, what to expect, and the paper work and forms, Oye Vey! Part of me is frustrated (and panic’d) that we’ve dragged our feet for so long and another part of me wants to cut the two of us some slack and remind myself that “things happen when they’re suppose to, and if we didn’t do it before it wasn’t meant to be so if we’re doing it now, it’s the right time”, so, there’s that constant push/pull of reprimand and encouragement going on in my head (it’s getting awful noisy in there).

The first step was a lot of research (mostly online) finding out what to expect and the steps to take. The more I read and the more I learned it seemed like pretty dangerous water to navigate alone so it became glaringly clear was that we’d need a lawyer. Given the legal world we swim in it’s best navigated by sharks (i.e. lawyers) anyway. Don’t get me wrong, I have the utmost respect for lawyers, I just hate that I feel powerless in that arena, like I’m always having to depend on a lawyer to translate and interpret my options, the law and then advocate for me. And the whole process and outcome never seem to be as clear-cut as on TV. The way the system works you’re as good as “dead man walking” if you enter into a courtroom to represent yourself. The “legal-eeze” in the documents alone is enough to make you feel like a damsel in distress so that one of the lawyers on the TV commercials (from the firm of “Rip-off, fly by night and takes all your money up front with no guarantees of getting you want you asked for) appears to be your knight in shining armour.

So, it was with that skepticism that I started my quest back in April. First, I contacted the local chapter of Alzheimers.org and they gave me a referral list of lawyers in the area that specialized in elder-care (a growing market of lawyers that work with families on estate planning, wills, Power of attorney, etc). They even have an organization called “The National Academy of Elder Law Attorneys” (website: http://www.naela.org) and can be researched state by state.

The list for my area wasn’t that long which surprised me given that we live just outside a major Metropolitan area (and judging from the assisted living, retirement communities and the huge amount of space given over to handicapped parking in the local shopping areas) I assumed it would be like shooting fish in a barrel to find a lawyer.

There may not have been a plethora of lawyers to choose from it was a start and in the end all I needed was just one good lawyer that we’d been comfortable working with.

I wrote down a short list of specific questions that I asked each lawyer during my initial phone call to save time and to help eliminate lawyers that I didn’t think would be a good fit for our situation. I didn’t want to waste my time or theirs so I made a point of being very specific and stressed what my ultimate goal was for my mother and asked them about there experience doing what I needed. These were my questions:

1) My goal is to help my mother qualify for long term care in a nursing home and have Medicaid pay for all of it-how do I achieve that and respect her wishes that her home not be used to pay for her care?
2) What is the Medicaid “look back“ that I’ve heard so much about and are there any ways around it?
3) Is her current will valid?
4) Does she need “estate planning” if she has little in the way of assets?
5) Do you charge for a consultation and if so/what?
6) What is your hourly rate?
7) Do you charge by the project or by the hour?
8 What has been your experience working with “elder care”?
9) How many estates have you set up?

If I was lucky enough to get the lawyer on the phone (and they were gracious enough) to indulge my questions I took notes so that I could compare and contrast later. Asking about the Medicaid “look back” was the most eye-opening question because the laws have changed recently and one lawyer cited old information and it made me realize that I shouldn’t assume that “any or all” lawyers I talked to had the most current information.

I left messages with secretaries for those not available and it took the better part of a week to talk to the seven lawyers on my list. After eliminating the lawyer with the outdated info (that was no-brainer) and the one who said that eldercare was really not the mainstay of his practice, I was left with five to choose from and they all said and offered pretty much the same thing (with a slight variation on their hourly rate which ranged from $275 to $400 an hour) except one.

Interestingly, only one lawyer, Cheryl Chapman Henderson asked me a question none of the others did. After my standard “Q and A” she asked me, “Do you know about the VA Pension Benefit?” and when I answered “no” she proceeded to tell how Miss Cathy might be able take advantage of this little known program offered to widows of a veterans who served during a time of war (any war). She had piqued my interest with that little factoid so that exchange put her on the top of my list-I liked that she brought something to the table that I would otherwise never have known about.

She also told me that they hosted a free estate-planning workshop at her firm so I signed up, thinking it would help me to gather some more information that would help me make a decision as to how to proceed.

Next week Paper Chase: 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.

Give me my flowers as I live so I can smell them

Posted in June by

I took Miss Cathy to another funeral this morning. They seem to be one of the few things she gets dressed and leaves the apartment for these days. Hey, I’m just glad she’s getting out and “getting some air on her” as she used to say to my brother and me when we were little and she wanted us out of the house (and out of her hair).

It’s a fact of life that as you get old-old people around you start to die. Years ago, I remember asking my Pop about death and dying after so many of his friends crossed over. There was a period of time when it seemed that almost every time I called home he (or they) were going to a funeral. At the time this phenomenon was specific to Pop because he was considerably older than mom so they had friends almost a generation apart.

As a former New Yorker, where going to a shrink is as common as getting your bagel with a “smear”, I was prone to “navel gazing “ and introspection after my time on the couch so I asked him how he “felt” about his peer group passing on. He looked at me as if I wasn’t as smart as he’d given me credit for and said, “Well, how do you think I feel?” “ After your last friend dies all you’re doing is waiting for your turn.”

Now I’m wondering if Miss Cathy is thinking the same thing because the mood has been a little funereal around here. It doesn’t help that the sermon she was listening to yesterday on Sunday morning television was all about “Love, peace and passing on”.

She doesn’t get maudlin and she’s not a very sentimental person but every now and then, she gets reflective-especially around occasions like the one today.

So, yesterday, I was surprised when she stopped me as I walked through the living room, past the reverend and his sermon, on my way out to the balcony to enjoy the cool morning air. She said she wanted to tell me that she never forgot a trip I made in my car from Kansas City a few years ago when I drove nonstop and slept in my car for a few hours before getting here as soon as I could.

She said that it touched her heart that I would show my love for family by dropping everything and doing what I did. I told her it meant alot to me to hear her say that. I started to well up watching her get misty-eyed.

“I believe in letting people know what they mean to me while they’re around to hear it”, she said, “some people wait till it’s time to go to a funereal to let what they feel be known.” “I don’t believe in all that, that’s just a “show”.

Then she looked me in the eyes and said, “Give me my flowers as I live so I can smell them.”

Continue talking

Posted in April by

I got back from my “time off” last Thursday and unlike my other trips where I felt refreshed and energized this time was different. Unfortunately, the minute I got back it felt like I never left. Miss Cathy was chatting at me the moment I opened the door.

Of course a lot of that has to do with me and not mom, my personal life seems to be in transition so I need to establish a secure foundation and some structure in my life here.

It was great to see mom, she gave me a big hug when I walked through the door and not long after she was gone to spend some time with Adele leaving me some time alone to unpack and unwind. I could see that she had taken good care of the place while I was gone and there wasn’t much to do till I had to take her to the doctor the next day.

So, Friday morning I found myself sitting in the orthopedic surgeon’s office with Miss Cathy for one of her follow up appointments after her knee replacement surgery.

The office was a hot, non descript room full of old people in wheelchairs, casts, canes or some other indication that they won’t be signing up for Arthur Murray anytime soon. Everybody seemed to be there at the same time for the same thing. We all sat and waited to be called back into an exam room, most people killing time by talking and/or watching whatever god-awful midmorning television show happened to on the flat screen TV perched high up on the wall.

What was frustrating was that you make an appointment and show up on time but the reality is that you’re not going to see the doctor until he was good and ready to see you.
It’s an abuse of power that I have little patience for in my life but this wasn’t about me-it was Miss Cathy’s doctor and her appointment and I try my best to stay out of it.

Since this all started last year she’s shown very little patience herself with being kept waiting and her reaction can range from mild irritation to a complete melt down in the waiting room (so the apple didn’t fall very far from that tree).

Rather than sit anywhere near the television I chose seats on the other side of the room, thinking it would quieter-but no, but no (just my luck) we ended up sitting next to a couple that wouldn’t shut the f*ck up. The husband was a big blowhard of man. He talked just loud enough so that everybody else could hear his voice (his favorite sound I imagine) but no loud that’d think he was at sports arena. He sounded like a reject from the Henry Higgins School of snobbery and pretension so unless the front row of Wimbledon I don’t think you’d see him there.

It was hard to “not” hear someone so intent on enunciating so clearly in such an affected and old-fashioned manner of speech, making everything he said sound like it was occurring in 1938 New England and not an orthopedic surgeon’s office in suburban Maryland in 2011. The wife was a mousy thing, hanging onto his every word out of obligation or inertia, the perfect female compliment to his pontificating; she was the woman beside (or behind) the “man about town”.

Earlier, I was bemoaning the fact (to me, myself and I) that anytime I left my room I’d be subjected to Miss Cathy’s ramblings (I know she’s lonely but egads, can’t there be a moment when the two of us are in the same room and words need not be spoken?). But, this, this is an assault on my ears and I’m not even related to the man.

I do not want to hear this man’s opinions or anecdotes. I’d move but the only other option would be to sit near the other old people swapping stories about their particular ailments or surgeries as “Judge Punch or Judy” roared in the background. Oye! It’s Sophie’s choice!

I’d been back about 24 hours after being gone for two weeks and I felt as if I’d never left. I had a feeling it was going to be a verrrrry long day and it was, we spent more than two hours waiting for the doctor to come spend about ten minutes with Miss Cathy.

They took an x-ray then the doctor said that her knee was healing better than expected so she could expect more than 100% mobility and range of motion out of her artificial knee and she doesn’t have to come back for two years for another check up.

It occurred to me as we were leaving the doctor’s office that in the past (say three or four months ago) Miss Cathy would have been very angry and agitated by the long wait, complaining or making a mini-scene. Not this time, she was calm and didn’t complain, she mentioned the wait but it was just a statement of fact, in fact she was even trying to sleep to pass the time till her name was called.

It was a marked difference in behavior and I don’t know if it was because of her time alone or what but she definitely seemed to have a different attitude. I really have to give her “props” for how she handled herself and I need to try to follow her example.

I may not want to listen to her but I can still learn from her.

Voicemail

Posted in April by

“Hya son, I’m calling again. I just got off the telephone. I’m trying to look to see what time it is, I think this is….ahhhh, I can’t half way see the clock, looks like its twenty five minutes to eight. Well, anyway, I had called you earlier.

I’ve been on the telephone talking to Marcia so I don’t know if you had tried to call while I was on the phone talking to her. I didn’t get a signal, so anyway I was just letting you know. She said she’d be up tomorrow so anyway; I’m going back into the bedroom now to watch the “cooks” on TV.

I’m doing very well and I’ll talk with you later, love mom.”

That was a voicemail that Miss Cathy left for me not too long ago. We’ve bee playing “phone tag” for the a few days now (which is funny seeing how she never leaves the apartment). But, she discovered “screening” years ago when I first bought her an answering machine and now she just lets the call go to voicemail-listens to the message and then decides if she wants to call the person back.

She sounds good, she always leaves “mini” voice “letters” instead of messages, and I’ve always thought that was sweet.

By all accounts she’s doing well and has been enjoying her time alone. The upstairs neighbor, Ron came by one day last week and took her to the grocery store so I know that she’s gotten out at least once since I’ve been gone.

And I’m glad to hear that Marcia, another neighbor (downstairs) is coming up to visit.

I asked her to water the plants for me and she says she’s remembered the schedule of twice a week and the amount of water for each plant.

She says that she’s been keeping the cooking to a minimum (a promise she made to me before I left) and has been using the microwave to heat up a lot of the food that she cooked before I left-a lot of stews and casseroles.

I’m back on Thursday and have decided to get a part-time job out of the house since she’s doing so well (and lets be honest-I could use the money with art not selling like it used too). Depending on what I can find (I have few skills other than drawing for the past thirty five years so don’t be surprised if I’m you new barista at Starbucks).

So, whatever I get will be for about four to five hours a day for as many days a week. I think that being out of the house for a few hours each day will be good for both of us.

I think I’ll call her and let her know my plans…….oh, what do you know, it went to voicemail.