Friday, November 21, 2008

Back in SF


Here's another view from Dad's hospital window. We arrived back in San Francisco last night, after a call from Dad saying that he was being sent back to the Reno hospital, and that the SF VA would handle the transport, but that they had to wait for a bed. We decided to drive down, but joked that Dad might not be there by the time we arrived.

Instead, it's now clear that we'll be here at least until Monday, and quite possibly longer. Dad's had neither surgery nor catheterization -- on the grounds that the first would involve replacing two valves, for which he isn't strong enough, while the second wouldn't accomplish anything at this point -- so they're ready to send him back to Reno. The question is where and how, since they've decided that he doesn't need to be in the hospital anymore.

If he goes home, we have to drive him, a prospect that fills both me and Gary with alarm verging on terror. He's been choking a lot: what if he chokes in the car? What if he passes out when we're in the mountains fifty miles from the nearest hospital?

But he may not go home. He may go to a Skilled Nursing Facility, or SNF, pronounced "sniff." The physical-therapy and occupational-therapy people have evidently recommended two weeks of rehab, and Gary and I think that's a good idea, although Dad's less than thrilled by the prospect.

Dad's very nice doctor told us that if he goes to a sniff, she and the social worker will try to arrange transport, but that I should be trying to make my own arrangements in the meantime. The respiratory therapist told us that if he gets sent to a sniff, he'll definitely be transported by van. Whom should we believe? I guess we'll find out when he's ready to leave.

Meanwhile, when a bed in a stepdown unit becomes available in the SF VA, he'll be transferred there to free up the acute-care bed he's currently in. On Monday, the OT and PT people will reevaluate him. If they decide he can go home, we all leave Monday. If they opt for the sniff, Arrangements Must Be Made, which could take until Wednesday.

My dad's depressed about hanging around his hospital -- despite the gorgeous view of the ocean -- and he hates the idea of the sniff. Gary and I are hoping fervently for the sniff, both because of the transport issue and because we don't think he's ready to go home yet, even with home healthcare. It hasn't escaped our notice that the VA flew him out here for procedures that weren't available in Reno, and then didn't even do the procedures. *Sniff.*

Meanwhile, here's a photo my sister sent me of our mom when she was about to go home from the hospital. Mom's been told that she needs a new heart valve but won't be getting it because she's too old to be a good surgical candidate. Does this sound familiar? She refused to go to a nursing home for the physical therapy her doctors have recommended, even though she's been falling a lot, and even though the stairs in my sister's house are so steep that they make me nervous when I'm on them. So Mom's home now; my sister says she's doing okay in some respects but not in others, but I don't have details.

So that's the news. I'll post an update if anything changes (which it seems to be doing every five minutes, in through here).

Thanks to everyone for the supportive comments. I'm sorry I haven't had time to answer them individually!

Tuesday, November 18, 2008

Now It's Mom


My mother's in the hospital in Philadelphia with pneumonia and the beginnings of CHF (congestive heart failure). This is actually a relief to my mother, who expects to feel better there, and also to me, since she's been falling a lot and I've been worried. My sister and I have very different approaches to calling 911, and I got cranky with her yesterday because it sounded to me like a call would have been appropriate then. I'm glad she called this morning.

I'm also glad that my sister and I only have one parent apiece to deal with in person. Part of the rationale for Dad moving out here was to give my sister a break from caring for both parents, and right now, she must indeed be happy about that.

Sunday, November 16, 2008

Back Home


We're now back in Reno, supposedly until Thursday morning, although I never expect anything to stay stable for long these days.

We stopped for gas mid-trip, and I checked my Blackberry to find an e-mail from one of our priests saying that a prayer shawl for my father is waiting at the church. (The woman in our congregation who makes them doesn't like to be acknowledged in public, but I know who she is!) I was very moved by that, and so was Dad when I called him to tell him.

Must get back to class prep for tomorrow. What day is this? What state am I in?

Saturday, November 15, 2008

Yet Another Plan


Gary and I got to Dad's hospital room, with its gorgeous ocean view, around 9:30 this morning. Within two hours, we'd met a cardiology fellow, the attending, and the chief of the cardiology service (the person we'd been told had categorically denied Dad the valve replacement), not to mention several different nurses and a respiratory therapist.

We'd come here thinking that Dad would have the angiogram on Monday, and that it was important that I be on hand for the angiogram. However, the new plan is to work him up very thoroughly, organ system by organ system (they're calling in a GI consult, for instance, to see if there might be some GI reason for his anemia). The chief told us that Dad will be in the hospital a minimum of a week while they try to figure out if he can have, or wants, the valve replacement.

"But I thought you said you absolutely wouldn't do the valve replacement," I said. "That's what Reno told us."

She shook her head. "I never said that." She did say that he's high risk, but we already knew that: this is now all a matter of weighing risk factors.

She also said -- first time we've heard this -- that anyone with any heart condition is going to do much worse at altitude than at sea level, which makes Reno more dangerous medically for Dad than Phlly was. He'd asked his Philly doctors about this and they said it wasn't an appreciably greater risk. Oy!

Anyway, when I mentioned my teaching schedule, the doctor advised -- and Dad agreed -- that I should go back to Reno to teach my Monday-Wednesday classes, and return to San Francisco on Thursday. The angiogram will be done Wednesday or Thursday, probably, but they can talk to me on the phone if anything crucial comes up. The chief doesn't think I need to be on site for that, although I would in the event of surgery.

So Gary and I will drive back over the mountains tomorrow. My friend Ellen is letting us keep the key to her parents' house so we can use it again next weekend. What a godsend! And there's even someone at church who can take my preaching date, so that's all worked out very smoothly. (I haven't been to church since October 12, and I'm starting to wonder if I'll ever be back!)

I wonder where we'll be for Thanksgiving. Well, we'll work that out when we get there. One day at a time.

Anyway, all things considered, it was a pleasant day. We sat in Dad's room and listened to folk music on the radio, and I knitted. For lunch, Gary and I went to the Seal Rock Inn, within walking distance of the VA, which we think might be a fun place to spend spring break, too. For dinner, we joined Ellen and her family for her birthday celebration at a nice Italian restaurant.

We're assured of good driving weather tomorrow, since the weather here is gorgeous this weekend. I hope we have good driving weather next Thursday, too. I'm certainly putting miles on the car this month!

Dad's View from the SF VA

Pretty nice, eh?

Friday, November 14, 2008

We're in SF!


Fran and I were at the hospital this afternoon when the resident walked in, smiling, and announced that Dad would be transported at 6:00.

It was then 3:20. I raced to Fran's place to drop her off and then raced home, where Gary and I put out tons of catfood, threw miscellaneous luggage into the car, and took off to try to get across the mountains before dark (which we did, just barely). We were treated to spectacular Sierra sunsets, and in Sacramento, I saw a huge, orange full moon rising in the rearview mirror.

Dad took off about two hours later than planned, and landed just as we were finishing a light supper -- I was ravenous! -- at our friend Ellen's house. We're now at her parents' house (they aren't here at the moment); it's a lovely place with Internet, thank goodness, so I can use my laptop and not just my Blackberry. This will make handling work logistics for next week infinitely easier!

Okay, get this: Dad tells me that the woman in charge of transport told him that if he's okay in San Francisco, he'll be discharged in San Francisco, and will have to make his own arrangements to get home. He was told that he can book a plane flight or take a bus. What the hell? First of all, one of the nurses told me they'd fly him back to Reno for rehab, which makes sense: lying around in an ICU for a week makes you weak, especially when you're 86! How can they tell him to make his own travel arrangements? If they flew him 200 miles for a procedure not offered in Reno, shouldn't they also be responsible for getting him home? Dad has family and resources, but what would a patient do in this situation if he didn't?

We would, of course, drive him, but I'd be nervous about having him in the car for four hours straight out of the hospital, especially given altitude changes over the mountains.

This has to be wrong, doesn't it? I said to Dad, "If this is true, I think it's terrible, and I plan to fight it." Dad said, "I think you'll find that they're adamant."

Well, one thing at a time. We decided (with Dad's consent) not to go to the hospital tonight, because it was too late. We'll go tomorrow morning. In the meantime, we're all safe and have beds to sleep in. Thanks be to God!

Autumn Still Life

Gary and I just got back from a walk, on which I took this picture. I liked the play of light and shadow.

Thursday, November 13, 2008

Still Still in Reno


Dad's been pronounced stable enough to travel, and the cardiologist in SF has formally accepted him. I was at the hospital when these things happened this morning, and the very nice ICU doc said, "Are you ready to go? You need to be ready."

So I raced home, finished packing, and calculated how late we could leave and still have light getting across the mountains.

All to no avail, because a bed never opened up. The day nurse told Dad he'd probably go next week. The night nurse told him he'll go whenever a bed becomes available (which could mean tomorrow or over the weekend, theoretically).

Que sera sera, but this "hurry up and wait" business is becoming very draining.

Wednesday, November 12, 2008

Still in Reno


This morning Dad said he'd been told he'd be transported in two or three hours, so I canceled classes and got all hyped up on adrenaline again.

Then it turned out that he wasn't going today after all. The good news, though, is that he's off the dopamine, which presumably means he can go to a telemetry bed and doesn't need ICU. Also, he had an ultrasound of his carotid arteries which came out fine, and he got a blood transfusion to boost his hemoglobin count. He loves the Reno VA, and says it's the best one he's seen.

I could have reinstated my later class, but realized that I'd hit an emotional and physical wall: I felt like I was moving underwater, and like my sentences weren't quite coming out in English, and like my emotional barometer was completely out of whack. (This is reasonable after a month of insane stress, right? I'm not just being a wuss?) So I decided to keep the class canceled so I could come home, eat a hot dinner, pack, and crawl into bed. I managed the hot dinner: the other two haven't quite happened yet.

I want to thank everybody for all the amazing support we've gotten. One of my grad students gave me a beautiful stone heart, made of a mineral reputed to have healing qualities, and told me she'd prayed over it for me and Dad and then kept it close to her own heart "to keep it charged up." I've gotten many kind messages from other students. My colleagues are being very supportive. Church folk have been amazing: I got a call tonight from my church friend Bonnie, who's a nurse and visited Dad in the nursing home, asking if she could do anything to help. She's probably not working tomorrow, and Fran's decided not to go to SF -- partly to deal with her own health issues, including going to a doctor's appointment tomorrow afternoon -- so Bonnie offered to take Fran to and from the doctor and also take her shopping.

And, of course, my blog readers have been wonderful! Thank you for the messages you've sent, both public and private. I told Dad that Terri sent extra hugs and kisses and that Lee wanted him to post on the blog. He pondered a bit and then said, "Well, you can post on your blog from me that all hugs and kisses are lovingly received."

It's nice to feel overwhelmed by support after feeling overwhelmed by stress!

I asked Dad how he was feeling about everything. He says he's doing fine, and that his attitude is basically that he'll go along with whatever the doctors want. Fran seems to be holding up remarkably well too, partly because she's so grateful to everyone who's helped us out.

I should go try to pack now, and then crawl into bed. Please pray that we finally make it to the city tomorrow!

Tuesday, November 11, 2008

Irreversible Damage


The doctors in San Francisco have refused to do open-heart surgery on my father, because they feel the risk is too great in his case and because he already has irreversible damage to his heart that a valve replacement couldn't fix.

They're still willing to do the cardiac catheterization, though -- a much lower-risk procedure -- which might involve putting in stents, which might improve his quality of life. That procedure still has to happen in San Francisco, because Reno does diagnostic cath-lab stuff, but no therapeutic procedures.

The average survival time for someone in Dad's condition is two years. Being realistic, I know that someone who's eighty-six is a short-timer anyway, but I'd like his remaining time to be as vigorous and healthy as possible, and he's now lost his remaining chance of any dramatic improvement in quality of life. Of course, given the recovery time from open-heart surgery, it probably all evens out anyway.

Still, I was pretty upset when I heard the news. Fran told me when I went to the apartment to pick her up; Dad had talked to her on the phone. I thought it must be wrong, that one of them had misheard something. When I got to the ICU, I demanded that the nurse tell me what was going on. She said that Dad should tell me, but two doctors (both young and female) showed up very shortly thereafter, probably sent by the nurse, and explained everything. They understood why I was upset, but I still felt a bit like they were treating me like I was the problem.

Which, in that moment, I guess I was, since Dad was very calm about everything and Fran kept cracking jokes. (What's that I tell medical students? All family members react differently to bad news?)

Intellectually, I know that medical treatment reaches a point of diminishing returns, and I've always known my father was a bad surgical candidate; I was surprised when we were told he'd have the surgery. And I'm not a fan of torturing the elderly and infirm with horribly invasive and painful procedures, honest.

But emotionally, I felt like I'd just been punched in the stomach. Hope had been held out and snatched away again, and Dad had just been given two years to live. We'd just arrived at the "nothing more we can do for him" point. (The doctors said that there's a miniscule chance that when the SF team does the cath procedure, which is more informative than the other tests that have been done so far, they'll decide to go ahead with the surgery . . . but they emphasized that I shouldn't get my hopes up.)

I ranted a bit to one of the nurses -- she was Dad's nurse yesterday, but not today -- who nodded sympathetically and gave me a hug. I told everyone I was going downstairs to find the chapel. As I headed out the double locking ICU doors, today's nurse called out, "Susan! Wait! I want to talk to you!"

She followed me out into the hall and gave me a vigorous pep talk: reminded me that Dad's spent his life beating the odds (he was given six months to live in 1976, after all), told me what remarkable shape he's in given his age and condition. "He's the only patient his age I've ever had who doesn't have sundowners," the syndrome where elderly people become confused in the afternoon and evening. She told me what a "wonderful, smart" man he is, and how everyone in the unit goes into his room to get his views on political and economic events, and how proud he is of me and my sister. "I told him he should write a book, because he's had such an amazing life. I adore your Dad."

I adore my Dad too. I want him to be around for as long as possible.

She also ventured the opinion that "there are too many cooks in this kitchen." We're dealing with the cardiac team, the ICU team, and the San Francisco team, and they all have different opinions about what's appropriate. For instance, the doctors I talked to today said they hope to fly him out tomorrow, but other people on the medical staff believe that he shouldn't fly while he's on a dopamine IV, which is raising his blood pressure to a normal range. So we're definitely waiting for an ICU bed in San Francisco, but we may also be waiting for Dad to get off the dopamine drip, which so far hasn't been possible, because when they try it, his BP plummets again.

I appreciated the nurse's efforts to comfort me, but I still went to find the chapel. It's a pretty chapel, very small. The chaplain's office was dark and locked. I tried to pray, got distracted by noises from the hall, went back upstairs, and calmed myself with knitting.

Then I drove Fran home, and Gary and I went out for a decadent anniversary meal. I'm afraid I wasn't very good company tonight, either in the hospital or in the restaurant.

So, anyway, we're still in limbo. I don't know if he's going or when he's going. All I know is that if he goes, less will happen there than originally planned.

Birthday Boy

Monday, November 10, 2008

Not Quite Yet


Well, SF doesn't have an ICU bed, so Reno's trying to wean Dad off his dopamine drip so he can go to a telemetry bed instead. However, his nurse told me that she doesn't think they'll be able to wean him very quickly.

Stay tuned.

Road Trip


Dad was doing much better this morning: so much better that he'll be airlifted to San Francisco as soon as they can find a bed for him and arrange transport. That could happen as soon as this evening.

They'll do the cardiac-cath procedure there, too. They'd have to repeat it there anyway, and they don't want him to have two, since the dye puts pressure on his already compromised kidneys.

He has a 70 percent chance of surviving the surgery, but if he doesn't have the surgery, his chances of living another two years are only 50 percent, and his quality of life will be poor. Of course, his quality of life will be poor right after the surgery, too, but it represents his best hope of ever feeling better.

I'm waiting for the VA to call and tell me when the transport is happening. I have no idea how long I'll be gone, of course, which makes arranging for class coverage a bit dicey, but I'll figure something out in the next hour or two.

If there isn't a bed at the San Francisco VA, he may go to the one in Palo Alto. In that case, we'd probably still stay in the city, although of course the drive to the hospital would be much longer and hairier. We're greatly blessed by the fact that one of my best friends lives in San Francisco, and her parents have a house there which they aren't using at the moment, where she's told us we're welcome to stay. (Thank you, Ellen!)

I'll post specifics when I have them. In the meantime, Gary's home doing laundry and packing, and I'm at work, clutching my cell phone.

Please pray for good weather. I hate driving in any amount of snow, but snow over Donner Pass can close I-80.

Hope and Healing


Today is the Grand Opening of Hope and Healing, the website about faith and wellness for which I'm writing a monthly column called "Bodily Blessings."

If you go to their homepage, you'll see a link to my first column, which is about knitting. This piece is very dear to me, and the timing of the publication is poignant. Tomorrow's the first anniversary both of Bill's death and of the scattering of Scott's ashes. (Tomorrow's also my and Gary's thirteenth wedding anniversary, the nineteenth anniversary of the day we met, and Bali's second birthday . . . and Veteran's Day, of course. Talk about a bittersweet occasion!)

I hope you enjoy the column, and the rest of the site.

Sunday, November 09, 2008

Dad's Condition


My father's in "guarded" condition (better than "serious," but not as good as "stable") in the ICU. He has low blood pressure, and his kidneys aren't working right, and the meds that would raise his blood pressure would also "nuke his kidneys," to quote the doctor's colorful phrase.

Ideally, the next step will be a cardiac catheterization to see what's going on other than the bad valve (which they know he has, and which could have caused the heart attack). However, at the moment his BP's too low for him to tolerate that procedure, so they can't go in until both the BP and the kidney issues have improved.

After he goes to the cath lab, the ideal next step would be valve replacement -- open-heart surgery -- which the doctor estimates he'd have a seventy percent chance of surviving. The problem with that, of course, is that they'd have to crack open his chest. He had a really tough time recovering from his four-way bypass seven years ago, and he's frailer now than he was then.

If they do the surgery, he'll be care-flighted to the San Francisco VA for it, since Reno doesn't have the proper facilities. But there are a lot of "ifs" floating around here, and the doctors have no idea what will happen. We're taking it day by day.

He was in excellent spirits this morning. This afternoon, he conked out and slept so deeply that neither the nurse nor I could rouse him when it was time to take his meds (the nurse was less worried about that than I'd have been if she hadn't been there). I like the medical staff, and I think he's getting good and appropriate care.

This morning, he decided that he wants to be DNR ("Do Not Resuscitate," medicalese for "if my heart stops, let me go"), so he's now wearing a bright blue bracelet announcing his code status. While the doctor, intern and resident were briefing him and me and Fran on all the steps and permutations and complications, Dad kept waving at the ceiling and saying cheerfully, "Hi, heaven, I'm on my way!"

This was purely a figure of speech; he's a devout atheist who believes neither in heaven nor hell. But later, when one of the doctors told me that he wasn't sure Dad understood his situation, I said, "He understands his situation exactly. That's why he was saying hello to heaven." (Don't these people listen?)

But with any luck, we can delay that for a little while.

Another Day, Another Hospital


Yesterday, Gary and I and four friends spent several hours moving unwanted furniture out of the apartment and wanted furniture into it. Then Gary and I spent several more hours unpacking. Then I went grocery shopping for Dad and Fran.

I got home around 7:00, ate dinner, and settled in with a pot of peppermint tea to grade papers. At 8:30 the phone rang: it was Fran, panicking because Dad had just had a strange shaking spell and she couldn't get him to bed.

I rushed over there; he was conscious and didn't want me to call anyone, but I called home health anyway. They advised me to call 911, and the ambulance crew actually got permission to take him to the VA hospital. Dad and I were joking, "Well, this is one way to get to the VA!"

At the VA, various tests revealed that he'd had a heart attack, and he was admitted to ICU. He was alert, joking and relatively cheerful through all of this. I spoke to him this morning, and he said he feels "chipper," although he had a central line put in last night, and that's been bleeding fairly steadily.

I didn't go to church this morning; I did something to my back moving furniture yesterday, and had a lot of trouble bending over to retrieve cat food bowls this morning, so I wanted to give my muscles some time to stretch out and rest. I'll pick Fran up around 11:00 and we'll go to the hospital to see Dad.

It was strange being in the VA ER. It's tiny -- smaller than the old one at my hospital -- and was staffed by one doctor, two nurses, and a few techs. I only saw one other patient there, who was also being admitted to ICU. Dad raved about the prompt service he got, and when I said, "Well, it seems quiet here tonight" (I didn't want to repeat my standard line about how you never want to be the center of attention in an ER), the tech drawing his blood shook her head and said, "This is medium busy."

Jeez. And they routinely turn away ambulances? I know that's a function of critical-care beds and not of ER gurneys, but still.

Also, my age is showing. The paramedics all looked like they were twelve, and the doctor looked fifteen, although he seemed as harried and overworked as any doc at my hospital. The nurse was my age, thank goodness.

Anyway, everyone was very nice, and Dad was pleased to have gotten an extra-large cubicle, although to me, it looked suspiciously like a code room (another thing I didn't want to tell him).

I am, as you might imagine, tired as well as sore, and I still have all that grading to do. We'll see how the day goes. I'll call in sick tomorrow if I have to, especially if my back isn't better, although I certainly don't want to.

Saturday, November 08, 2008

Dad

Fran

Sabbatical


I forgot to mention that I'm taking a sabbatical from my volunteer work for the month of November, so I can concentrate on getting Dad and Fran settled. I just hope I get to go back in December, as planned!

When I was with Fran in the ER yesterday, some of the staff thought I was working, and when I explained that I've been spending nearly as much time there as a civilian as when I volunteer, they laughed. I'm just glad I've been able to take Dad and Fran to an ER where I know people (and know where the warm blankets are!).

Friday, November 07, 2008

Never a Dull Moment


Yesterday, Dad finally came home from the nursing home. Hurrah! Of course, the discharge procedure involved endless bouts of sitting around: waiting for the doctor, waiting for nurses, waiting for paperwork, waiting for an oxygen cannister for Dad to take home. With all of that, we didn't exactly get discharge instructions; a nurse shoved a shopping bag full of meds and a ream of paperwork at me and said, more or less, "Here you go! Bye, now!"

When we got to the apartment, we had to wait some more, for the home oxygen guy to show up. In the meantime, we tried to make sense of the shopping bag of meds: Dad ultimately decided to keep taking his old stuff from the Philly VA until he can get into the Reno VA. Then the oxygen guy came and showed me how to switch to a new tank, a complicated procedure involving tricky bits of machinery which I'm afraid I didn't retain very well. I like the concentrator much better: all you have to worry about is an on/off switch, not levers and washers and guages and the fear that if you bump the thing funny, it will take off like a rocket across your living room.

After the washers and guages, we moved on to yet another ream of paperwork. I just signed whatever was in front of me. (At this point, I'd sign a Ritz cracker if you put it in front of me.) During this process, Dad lay down to take a nap, whereupon the oxygen guy -- no fool he -- started giving me a stern little pep talk. "He needs his rest, and you need your rest. I see this all the time: families get completely overwhelmed. I've taken care of my own parents, so I know what it's like. You need to take care of yourself, okay?"

I knew that. I really did. But I was almost absurdly grateful that one of Dad's caregivers was taking time to pay attention to what I needed, instead of just asking me to sign reams of paperwork (which I was doing even during the peptalk), sort out a pharmacy's worth of prescriptions, and somehow "make" Dad follow instructions. (Yeah, good luck with that. You herd cats much? And how's that working out for you?)

After the oxygen guy left, I took Fran to the bank and then grocery shopping, and carried stuff upstairs for her and helped her put it away. Then I went home, exhausted -- I'd hoped to swim yesterday, but no such luck -- and tried without success to take a nap. Then Gary and I went out to dinner, where I inhaled gallons of liquid and acres of food (when I got home from Dad's apartment, I realized that I'd had nothing to drink since my morning coffee, and that I hadn't exactly had a large lunch, either).

Before we left for dinner, the home healthcare nurse called to say she'd be visiting Dad this morning, and could I be there? I said I would. She asked me to hide any meds he wasn't actually taking so she wouldn't have to list them on her sheet, and I said plaintively, "That means I'd have to go back over there tonight."

"Never mind," she said. "We'll do it tomorrow."

This morning I woke up bright and early and got a swim in before going over to meet the home nurse. Hurrah! And a good thing, too. When I got there, the home nurse wasn't there yet, but Dad and Fran were both upset. She'd had strange dizzy spells, one in the evening and one in the morning, and Dad -- whose mother died of a stroke, and died in his arms -- was terrified that they were TIAs.

Me: "If you thought she was having a stroke, why didn't you call 911?"

Dad: "I didn't want to scare her."

Me: "She has to go to the hospital."

Fran: "I'm fine now. I don't want to go to the hospital."

Dad: "You have to go to the hospital. I need you to be around for a while."

Fran: "I feel fine now."

Me: "You could feel fine now and then stroke out. Little strokes can precede big ones. You have to go to the hospital." (Yeah, I know, I shouldn't have scared her like that, but it's the truth.)

Fran: "I don't want to. Can we wait until the nurse comes?"

Me: "No. You have to go now." (thinking, You should have gone last night.) "I'll drive you over there and then I'll come back here to meet the nurse, okay?"

And yeah, I know: I should have called 911 myself. But Dad was afraid of another bill, and she really did seem fine, and I wasn't thinking clearly. In the event, we got to the hospital without any trouble, and they took her right away and ran a bunch of tests, all of which were normal, and she was discharged a mere three hours later. People spend longer than that in the waiting room! She's supposed to follow up with a neurologist, with whom I'll make an appointment next week (I called today, but the office closes early on Friday).

So that was a huge relief. In the meantime, I'd zipped back to the apartment and met the home nurse, a kind soul who thanked me for having already hidden one shopping bag of meds in the closet, and who patiently cataloged the other shopping bag of meds, and who's going to dispatch an army of visiting healthcare professionals for Dad. His dance card includes an occupational therapist, a physical therapist, a home health aide to help him shower, and a social worker who'll help him (and Fran) get set up with local services. I'm just glad that all these people are making sure he's okay. While he's getting home healthcare, though, he's under a weird form of house arrest: he can go to any doctor's appointment, can leave the house once a week to grocery shop, and can attend special events like birthday parties, but otherwise has to stay home.

Very strange. He had home health both in Mississippi and in Pennsylvania, and I don't remember anything like this before. But Dad didn't protest.

I'm very glad that Medicare will be covering this. Each nurse's visit costs $158; therapy visits are $200. We weren't given a price for the social worker, but I'm sure that's steep, too. Yowsa!

Anyway, he and Fran were in good spirits when I left them; the morning's scare had become something we could all laugh about. Let's hope it stays that way!

Tomorrow's the Grand Moving Adventure, in which we remove extra furniture from the apartment and move in the stuff that Fran wants from the storage unit. After that, unpacking can begin in earnest.

Stay tuned for more exciting adventures! And forgive the length and incoherence of this blog entry. My brain's not working very well right now.

Tuesday, November 04, 2008

And for your viewing pleasure: Cats!

Family Update


For those of you following The Saga:

* I've recovered from the Awful Stomach Virus, and today I swam for fifty minutes, which felt awfully good. I also saw my psychiatrist today and mentioned that I thought starting therapy again would be prudent, but that I'd like to do something other than conventional talk therapy. Art therapy would be great. Unfortunately, she doesn't know any art therapists in Reno who work with adults. Pfui! Well, I'll keep asking around.

* Fran's movers showed up at the storage unit yesterday. The unit we'd rented wasn't big enough, so we had to rent another one. Because I had to work and didn't have time to rent a U-Haul and schlep stuff back and forth, we just made sure that all of her stuff got into storage. Next steps: 1) Remove from the apartment extra furniture Dad and Fran won't need, including an extra bed, 2) Move into the apartment the furniture they'll actually be using, and 3) Unpack everything. This process will begin on Saturday, when I'll rent a U-Haul which Katharine has offered to drive for me. (Thank you! I hate driving U-Hauls!) Would any local readers like to help us lug furniture?

* Dad's champing at the bit to get out of the nursing home, but hasn't seen his doctor since Friday. Once the doctor puts the discharge orders in, Dad can leave the next day, after the social worker's set up home oxygen, etc. But since the DME companies don't deliver oxygen equipment on the weekends, he'll have to come home next week if he hasn't made it home by Friday. Dad has, as he describes it, put out "an APB" for the doctor, and I spoke to the social worker, who left a note for the doctor asking him both to speak to Dad and to call me. Fran and I are just hoping that Dad will be somewhat politic with the physician, with whom he's furious, since he can't afford to antagonize the people who have the power to let him go home.

* The cats are all well, although very disappointed that the sick humans who served as such lovely soft radiators over the weekend are all better now. On the other hand, that makes the humans more reliable providers of catfood.

Hallelu, Nevada's Blue!


Wow! I actually voted for a candidate who won! This hasn't happened very often! And he's the first President of a Color Other Than Lily-White! And he speaks eloquent English! And Nevada voted blue! Amazing! We're always red!

Ironically, Gary and I came home from a victory party at our friend Katharine's house to discover that the Obama/Biden sign in our yard was gone. But, y'know, that's okay. The person who took it can have it: we don't need the sign anymore. We have the real thing.

On a completely trivial note, I'm of course wondering what kind of puppy the two girls will be bringing to the White House. (I gotta say, I loved that moment in his speech; but then, I pretty much loved the whole thing. And McCain's concession speech was extremely gracious, marred only by the booing at the beginning when he mentioned Obama's name.)

On a serious note, I wouldn't want Obama's job for the world. What a mess he's walking into! I just hope he fulfills the emergency-worker oath to "leave the scene better than you found it."

Saturday, November 01, 2008

Changing of the Guard


Gary's now quite a bit better, and I'm sick. So far, I only have the second half of the symptoms -- maybe I somehow skipped the prelude? -- with a low-grade fever.

More later.

Friday, October 31, 2008

Halloween Critters!


This darling kitten, who's named Black Bart, lives with Dad and Fran's down-the-hall neighbor, Bill, who adopted him from the Humane Society. Bill likes to take Bart for walks, and Gary and I have met them several times before, but always in the building. Today, they were outside; Bart was on a leash that Bill had secured to a tree, so the kitten could explore a bit without getting away. It took some doing to get this photo, as Bart's camera-shy. Bill hasn't been able to get good pix of the cat, so I e-mailed him this one. Very fitting for the day, isn't it?

Earlier, I had an even more special treat. During my walk, I saw two gorgeous coyotes trot across the road right in front of me. They ran up a hill and stayed there for a moment -- poised, alert, sniffing the air -- and then, with a glance at one another, took off again in unision. I headed in the direction they'd gone to see if I could get a look at them again (and maybe get a photo), but although I heard yips in the brush, I never saw them. They were wild and alien, magical, and thus as fitting to Halloween as Bart was, although in a different way.

In more pedestrian news, today I got Dad's banking straightened out, paid his November rent (I'm listed on his account, so I can write checks for him), went by my local yarn shop to get a snarled project fixed (successfully!), and had a very nice visit with Dad, who'd had an equally nice visit with my friend Bonnie from church, who'd very kindly stopped by to see him.

I also spent a little time with one of Dad's neighbors in the nursing home, who'd been cruising the hallways in her wheelchair, announcing plaintively to anyone who looked at her, "I'm dying!" She pretty clearly has Alzheimer's, but she was just as clearly frightened, lonely, and desperate to tell a story no one was listening to, at least at that particular moment. So I went into chaplain mode, and listened long enough to extract a coherent narrative: she's afraid to die alone, and she wants to see her daughter, who lives several hundred miles away and is too busy with other family to visit. She'd like her daughter to be with her when she dies.

She liked holding my hand; she repeatedly reached for it, and then squeezed it. Sometimes she stroked my shoulder. She kept saying, "I know you're a good person," and, "I know you're busy," and, "thank you."

I ran all this past an uninterested nurse, who confirmed that there's a daughter in the specified town several hundred miles away, and told me that said daughter understands her mother's condition but is too busy with personal family matters -- "I can't tell you what they are, because of the privacy laws" -- to visit the nursing home.

I can imagine a lot of legitimate situations that could keep someone from visiting, but I also found myself wondering how much of the problem was inability to face a disintegrating parent. I've seen a lot of elderly people suffering from Alzheimer's simply abandoned at the hospital -- dumped in the ER by a spouse or grown child who then vanished -- because their families couldn't cope any more. I'm not sure I'd be able to cope in that situation either, but I hope this patient hasn't been abandoned that way. Either way, the situation's heartbreaking, and I'll try to talk to her for a few minutes every time I visit Dad.

Dad's hoping to get home by Wednesday. The nurses seem a bit skeptical, but I think it's great that he's so motivated. And I'm intensely grateful that he's mentally intact. I read him New York Times headlines from my Blackberry because he was starved for news. No Alzheimer's there, thank God!

Stomach bug update: Dad's better. Gary's mostly better, but weak. Fran's weak with periodic relapses. I am, so far, healthy.

Knock wood.

Happy Halloween!


Happy Halloween, everybody. It's gray, cloudy and windy here, very fitting for the holiday.

Gary is out of bed and feeling better. I woke up with a horrible headache this morning, but it's subsided with coffee and Tylenol, and so far (knock wood) I don't have any other symptoms. I'm going to go for a walk in a little while, and then try to get some schoolwork done.

Fran's movers arrive Monday -- early in the morning, we hope, since I have to teach in the afternoon -- and will be delivering her stuff directly to the storage unit, which, with any luck, will hold it all.

I just spoke to a sympathetic woman at the VA who says that there's no way to establish Dad's benefits any sooner than his new-patient appointment (currently scheduled for 11/20, and unlikely to be moved because of the pressure of service-connected needs), but that once he's established, the VA will at least look at the $909 ambulance bill. She couldn't promise they would pay any of it, but at least there's a chance that they might. At any rate, I'm satisfied that I've now done everything I can.

Yesterday I tried, unsuccessfully, to reconcile my father's checkbook. I'm horrible at dealing with my own finances, so handling his has unnerved me. My sister suggested, sensibly, that I go to the bank to get a statement or two. That should help!

The pressure of all this caregiving has really hit me hard, although various people have told me that's completely normal. A nurse friend said, "Okay, so they just got here, and it's been nothing but a string of emergencies, and you're probably wondering, 'Is it always going to be like this?'"

I said, "Yes! Yes, exactly! You read my mind!"

I've realized -- no great insight here, but it's still important -- that I can't count on ever having a calm day, so I need to set my priorities for each day as soon as I get up. Exercise and getting some of my own work done are right up there. These are the things I can't afford to defer, since if I do, I might not have another opening for them that day. I have to take every chance I can to catch my breath and attend to business-as-usual.

As much as I hate the idea, I'm wondering if I should take a sabbatical from volunteering at the hospital. But it probably makes more sense to volunteer when I can. I'm afraid that if I gave it up completely, I might never get to go back.

Next week I see my psychiatrist for my periodic meds-management appointment. I'm going to ask if I can start therapy with her, or with someone else in her office, because if I ever needed someone to talk to every week or two, it's now! Friends have been supportive and helpful, but this is still a lonely, scary business.

Everyone (including my father, who's genuinely concerned about my stress level) keeps telling me that I'm doing a great job. That's good to hear, although I'm not sure "great" is the operative term. I'm doing as well as I can; right now, I'll settle for "good enough"!

Thursday, October 30, 2008

Battening Down


On Monday, Dad's movers called to say that they'd arrive at the apartment at 8:30 Tuesday morning. The plan was for Fran to let them in, and for Gary and me to arrive later, after they'd left, to start unpacking.

But at 8:00 a.m. on Tuesday, the phone woke me from a sound sleep. It was Fran. "Susan, help me! I'm so sick I can't even get out of bed!" She'd been up all night with one of those gruesome, spouting-at-both-ends stomach bugs.

I went over and let in the movers. Then I went home and got Gary, and we returned to the apartment and did some unpacking. He also cleaned up various bodily fluids.

That evening, I went to the nursing home. Dad was coming down with the same thing. A friend of mine who works at the hospital says this bug is Going Around, and hitting the elderly especially hard.

Yesterday morning, Fran and Dad were both feeling much better, but by the evening, they were both feeling worse again. And last night, Gary got it: he's thoroughly miserable and hasn't yet gotten to the point where he can keep anything down, or in.

I'm doomed.

This thing is your classic 24-hour bug (at least in otherwise healthy people), so at least it doesn't last long. But at this point, I figure it's a matter of when, not if. I'm thinking norovirus, which I had last May after WisCon, but unfortunately, that doesn't mean I'm immune: there are about 80,000 strains, and getting one of them only renders you immune to that one, and only for a little while. And I think I had some early warning symptoms yesterday (the same type I had at Wiscon a day or two before the beastie hit in earnest).

So I've set up my study as a sickroom: made the bed, put out the tissues and barf bowl, arranged knitting, reading and grading close by. I went to the supermarket and stocked up on Gatorade, and also got some frozen lemonade pops for Gary, since he asked for them. I made sure we have bananas, tea, and applesauce, three elements of the classic BRAT diet. We always have rice. I'm staying home today, because I figure that I'm probably shedding virus, and I don't want to reinfect Dad or Fran or infect anyone at the pool. (I'd already canceled my hospital shift, just because I'm so exhausted from everything that's happened since Dad and Fran got here.) The incubation period of this puppy appears to be one to two days, so if I'm going to get it, it will probably hit between today and Saturday.

If I do get sick, I'll be as prepared as possible. It feels like preparing for a hurricane or a blizzard. And if I'm prepared, maybe I won't get it, right?

In the meantime, I'm trying to take care of Gary even half as well as he takes care of me when I'm sick!

Reno Dawn

We had some very dramatic clouds this morning. The photo doesn't really do them justice, of course!

Saturday, October 25, 2008

Good Stuff, But


1. Dad's bleeding has stopped, so he's definitely going to the skilled-nursing place tomorrow (but he has a nasty cough, which worries me).

2. I swam for an hour this afternoon! It was wonderful! And for most of the time, I had the entire pool to myself! (but exercise looks tight for the rest of the week, which will be a challenge).

3. I got some grading done (but not enoough).

Friday, October 24, 2008

Continued


Well, things mostly worked out today. The package arrived, and we got the extra keys we needed, and Dad made it through the second, exploratory procedure. One of his nurses told me that they removed "three or four golfball-sized blood clots" (yes, that's an exact quotation) and cauterized the arteries they'd come from. Some veins were still oozing, and the nurse says those can't be cauterized -- although she doesn't know why -- but with luck, the bleeding will stop now, so Dad can be transferred to the skilled-nursing place on Sunday. The new facility is much farther away than the one where they'd originally planned to send him, but it's also in an exceptionally pretty part of town. Dad likes nice views, and he has a lovely one from his hospital bed, so I'm hoping he'll have a nice one at the other place, too.

I punted on my second meeting at work, but went to the first, in a fashion. I was meeting with a med student who's studying narrative medicine, and I'm afraid I spent too much time talking about Dad, but she was very patient and understanding (hey! I was giving her a chance to practice NM!). She gave me a stern little lecture about protecting my own boundaries. That really is important; I haven't been sleeping very well this week, although I've eaten well, thanks to Gary. I haven't exercised, though, and I keep forgetting to take meds -- including, at least once, my antidepressant -- and my classic depression chest-pain symptoms have come back. So tomorrow, my first priority is to get back to the pool!

Today I got a lovely e-mail from one of our parish priests, asking for an update on Dad. I called her this evening and we had a nice talk. She's visited people in the place Dad will be going, and says it's pretty nice (although she prefers the original place), and that the staff there have always been exceptionally kind. She's going to try to visit Dad in the hospital this weekend, just to give him someone new to talk to: he thrives on social interaction, and I'm anxious to use that to keep him from any cognitive deterioration. Right now, he's sharp as the proverbial tack, but institutional settings take their toll, especially on the elderly, and Fran and I run out of things to say after a while.

Everyone at work has been great: colleagues have given me hugs, offered tea and sympathy and class coverage (which I hope I won't have to use), and affirmed that this is anything but a business-as-usual situation.

Speaking of which, I have no idea how I'm going to get all my grading done this weekend . . . but my students would probably be understanding too, if it came to that.

Stay tuned.

Are We Having Fun Yet?


8:30 a.m. Ambulance company calls to ask about Dad's insurance. Medicare doesn't apply; therefore, the bill will be $900+.

8:45 a.m. Hospital social worker calls. Dad's being sent to a nursing home for rehab today. Here's a list of covered nursing homes: which do I want? I have to decide now. Flustered and upset, I pick the only one I've heard of. The good news is that the nursing home will handle transport, also covered.

9:00 a.m. I pick up Fran to take her to her doctor's appointment, and drop off Gary so he can wait for a package Dad's expecting.

9:30 a.m. Fran and I manage to find the doctor's office, located in a bewildering, miles-long maze of industrial park.

9:35 a.m. We discover that Fran does not now have, and has never had, a Medicaid card. (She does have a Medicare card.) We also discover that she never got the packet of mandatory new-patient paperwork.

9:45 a.m. I finish filling out the paperwork for Fran, asking questions very loudly so she can hear me -- "DO YOU HAVE ANY DIGESTIVE PROBLEMS?" -- as everyone in the waiting room pretends to ignore us. So much for HIPAA.

9:50 a.m. I start knitting to relax.

10:20 a.m. Fran's finally called into the doctor's office.

10:45 a.m. My cell rings. It's the social worker again. Dad's wound is still oozing, so at noon he'll have the pacemaker rechecked, and possibly replaced. His transfer to the nursing home is now scheduled for Sunday, but the original nursing home doesn't transport patients on weekends, so here's the name of another one that does that's supposed to be good. Is that okay with me? "Sure," I say weakly, just hoping Dad will be ready to go anywhere on Sunday.

11:35 a.m. I'm still waiting for Fran to finish her appointment, and I have meetings starting in two hours, so I don't think I'll be able to get to the hospital until much later this afternoon. (I can probably get out of my later meeting, but not the earlier one.)

To be continued. . . .

NM in the NYT


Many thanks to alert reader hhw, who sent me a link to this article about narrative medicine in the Times.

The article's by Pauline Chen, a fine practitioner of the discipline in her own right. I highly recommend her book Final Exam: A Surgeon's Reflections on Mortality.

Happy reading!

Thursday, October 23, 2008

Got Lists?


Today's Discoveries:

1. Being in the ED as a chaplain is much, much more pleasant than being there as a family member, especially during a relatively calm shift.

2. If one hasn't knit in almost a week and goes to the hospital gift shop to find something for one's father, and sees on a shelf a cutesy little scarf-knitting kit with actually fairly attractive yarn, one will experience acute knitting withdrawal, characterized by painfully itching fingers and an overwhelming desire to count stitches.

3. Knitting at one's father's bedside while watching TV with him (after going home, eating dinner, and fetching one of several current knitting projects) is much, much more pleasant than going through knitting withdrawal.

Tomorrow's Plans:

1. As early as possible, contact hospital to learn plans for Dad. These most probably consist, at this point, either of keeping him where he is (because his blasted wound is still oozing, even after the epinephrine) or sending him to a rehab unit (since he's very weak, and it took three nurses to get him on his feet today).

2. At nine a.m. or thereabouts, drop Gary at Fran and Dad's apartment so he can wait for FedEx package containing Dad's precious Bose radio while Susan drives Fran to the eye-doctor for a 10:00 appointment estimated to last several hours.

3. After dropping Fran back at the apartment and driving Gary back home, attend meetings at work from 1:45 to 5:00.

4. If there's any spare time between #2 and #3, a) have copies of apartment keys made so Fran, Dad, and Gary&Susan can all have a set, and b) try to get some grading done.

I think I'm forgetting something in there. I'd love to be able to add a swim to this list, but that seems very unlikely. I have to swim on Saturday, since my back's started whining. I haven't been swimming since last Saturday, before we drove to Sacramento to pick Dad up, although I did manage to get a walk in yesterday morning.

I really hope things settle down soon (ha! ha!), because -- among many other reasons -- I'm beginning to get a mite cranky, although a nice swim will probably fix that.

And for your viewing amusement, here's a photo of one of two matching sculptures in the baggage-claim area of the Sacramento Airport (which Gary called "a whimsical yet understaffed airport," because we both loved the sculptures but were annoyed by the fact that no personnel from Dad's airline were available to give me a gate pass).

This sculpture seems like a fitting metaphor for my life at the moment! And yes, I know, things could be much worse. I'll be less whiny when I've had some sleep.

And on that note, good night!

Wednesday, October 22, 2008

Logic? What Logic?


Dad's discharge has been delayed until Friday; his wound is oozing a little, evidently since he moved around too much yesterday, so he's currently pinned to his bed by a giant ice pack with orders not to move unless he's eating. If ice and pressure don't work, the doctor will give him an epinephrine injection. I never knew that stopped bleeding; I thought it just made people hyper. I hope he'll be able to move after he gets the shot, or else he'll really be antsy!

He's not enjoying this process. I wouldn't either.

Meanwhile, we're having tons of fun with health coverage. Dad has routinely gotten his care from the VA, but also has Medicare A. He dropped Medicare B (which is essentially outpatient stuff) years ago because the VA was providing those services.

However, since he just arrived in town, he can't receive any services from our local VA until he's gotten established with a primary-care doc, which means that he needs a new-patient appointment, which is currently scheduled for November 20. That's the earliest opening. I'm calling over there every day or two to see if there are any cancellations so he can get in sooner, but I fully understand how swamped they are.

This means that, for at least a month, we'll have to pay out-of-pocket for expenses Medicare B would ordinarily cover. Dad will need home oxygen and home health care after he's discharged. The social worker on his floor was pretty sure that A would cover oxygen, but not home health, which made sense to me. Breathing's more basic than having somebody come over to check your vitals, since if you can't breathe, there won't be any more vitals to check. (Dad quickly desats to 80% on room air, which is truly alarming.)

The social worker called this morning, after doing some research, and told me it's the exact opposite. The home health visits will be covered by Medicare A, but oxygen won't be.

Huh? Are they considering oxygen a prescription drug? I mean, it is, but does that mean that, say, insulin isn't covered by Medicare A either? I thought Medicare A might be just in-hospital stuff, but in that case, home health wouldn't be covered either. The social worker seemed as puzzled by all this as I was.

It's all very confusing. But the good news is that he'll be receiving both services, and that the oxygen (the price for which the social worker gave me) won't break the bank.

Have I mentioned lately that I love social workers? This woman's cheerfully willing to make all kinds of phone calls to make arrangements, whereas entirely too many of the other people we've been dealing with have a "don't ask me to step outside my own carefully circumscribed little box" attitude.

Yay, social workers!

The Latest


Dad's pacemaker implantation went well yesterday, thank goodness, although he already seems annoyed and impatient with the fact that he can't move his left arm while he heals (and won't be able to lift it over his head for a month).

Meanwhile, his doctor now thinks he needs a valve replacement, which would entail open-heart surgery -- ugh! -- and I'm still leaving lots of phone messages at the VA to try to get him in to see a doc for followup care.

Gary and I, along with assorted wonderful friends -- thank you! thank you! -- got the temporary furniture moved into the new apartment yesterday morning, so Fran's staying there now instead of at our house. She likes it a lot, even minimally furnished. The nicest thing in the whole place right now is the daybed some friends of us gave her, which is where she's sleeping. (We also have a double bed for Dad.)

As of yesterday, Dad and his nurse both believed he'd be coming home today. Fran and I are slightly skeptical, simply given his age. On the other hand, I know that hospitals try to move elderly people out especially quickly, because of the danger of hospital-acquired infections. I've told his nurse that he'll need both home oxygen and home healthcare, but I'm fully expecting to be told that I need to call the VA about that stuff, too.

Fran took us out for both lunch and dinner yesterday, which was awfully nice of her, given her terribly limited budget.

Stay tuned for more exciting developments!

Oh, the guy who lives down the hall from the new apartment has an adorable black kitten who likes to roam the hallways, and over whom Gary and I cooed and burbled several times yesterday. Everything's better with kittens.

Monday, October 20, 2008

Busy Busy Busy


What I did today:

9:00 Go with Fran to management office of new apartment. While Fran's signing three-inch stack of papers that also have to be signed by Dad -- this is as bad as buying a house -- get phone call from hospital social worker, who needs to talk to me about payment arrangements. Become alarmed.

10:00 While Dad is signing three-inch stack of papers (as tech who's arrived to do echocardiogram waits patiently because I've told her the papers have to be signed now), talk to social worker, who informs me that Medicare will, thank God, cover hospitalization and pacemaker, but won't cover outpatient visits. This means we need to get Dad established at VA, which we already knew. Social worker gives me phone number for VA.

10:30 Take three-inch stack of papers back to management office and accompany Fran and office manager on apartment inspection. Fran likes apartment. Yay!

11:00 Drop Fran back home, since if I took her to hospital she'd have to stay there until I finish teaching at 7:00. (It will only occur to me later that she could have taken a cab home.) Pick up lunch Gary's made me. Go to hospital to eat lunch with Dad, who hasn't gotten lunch yet but seems bothered neither by my eating in front of him nor by prospect of tomorrow's procedure.

11:30 Interrogate nurses about tomorrow's procedure, which will evidently take place in a cath lab, not an operating room, and last about an hour. Ask nurses if I should cancel moving plans to be at the hospital. They say no.

12:00 Run into friend from church who's working as a nurse on this floor, but who doesn't have time to visit Dad. Maybe tomorrow.

12:15 Leave for work. Run into colleague and fill her in on events of weekend. Watch her eyes widen. "That's enough for a whole year!" she says.

12:30 Try to organize self for today's teaching. Teaching? What's that?

1:00 Produce credible imitation of teaching in fiction workshop.

2:15 Return to office after class. Answer e-mail from two medical students who want to talk to me about the summer Narrative Medicine elective. Invite them to office to discuss it. Also call U-Haul place and rent van for tomorrow morning. Also call VA and, after talking to two different people, manage to leave message for new patient scheduler to call me for a post-procedure appointment for Dad. (The good news is that they already have his new address on file.)

2:30 Do some paperwork from 1:00 class.

2:45 The two med students, who turn out to be a couple, arrive with adorable dog. Coo over adorable dog. Talk about narrative medicine. Coo over dog some more. Show med students various books they should read. Rub dog's belly. Discuss summer schedule. Scratch dog's ears. Talk to students about stress of medical school; tell them dogs are good anti-stress medicine.

3:15 Medical students and dog leave. Office and self now covered in dog hair. Finish paperwork from 1:00 class. Answer e-mail.

3:45 Realize self required at committee meeting in fifteen minutes. Dash down hall to buy bottled water, use restroom. Run into colleague in restroom. Fill her in on weekend. Get hug.

4:00 Covered in dog hair, attempt to look alert and professional in committee meeting. Quietly compete with across-the-table-colleague to see who can eat the most chocolate (bowl of chocolate goodies provided by committee chair, who knows that chocolate makes people look alert and professional).

5:00 Meeting adjourned, return to office to get ready for 5:30 class in another building. Use restroom again. Realize that right lower arm is covered with smeared chocolate. So much for professional. Attempt unsuccessfully to divest self of several pounds of dog hair.

5:30 Teach class.

7:00 Class adjourned, return home. Call Dad to wish him luck with procedure tomorrow. Eat yummy dinner with Gary and Fran.

8:00 Return call from church friend who called house today to find out how Dad was. Receive call from church friend who'll help with move tomorrow, wondering what time and where to meet us.

8:15 Wish Fran good night as she goes to bed. Go with Gary to PetSmart to buy catfood. Coo over adorable cats for adoption. Can't get covered in cat hair, as cats separated from self by glass windows.

8:30 Go to supermarket to pick up last-minute items for apartment: ground coffee, dish drain, bucket, can opener.

9:00 At home, pick out extra towels and sheets to lend to Dad and Fran while they wait for movers.

9:30 Blog about busy day.

10:30 Good night!

Long Story Short


Dad arrived safely in Sacramento, and we got him safely home, but he fell in our garage trying to get into the house and is now in the hospital, awaiting a pacemaker (and in need of home oxygen, since his sats consistently drop to 82 without it).

Fran arrived safely yesterday, in the middle of Dad's ER admission. This morning, she and I will go to the new apartment and talk to the manager about how he can sign the lease (can I bring it to him in the hospital? can I drive the manager to the hospital so she can watch him sign it? etc. HUD has incomprehensible regulations).

There's much more I could say, but Fran just woke up, so I need to go get her coffee. All prayers welcome! (Dad's in good spirits; I'm somewhat less so.)

Saturday, October 18, 2008

Cat Tent

It's kinda like a pup tent, only different.

I took this photo before we left this morning. We're in Sacramento now, waiting for my father's plane.

Tough Old Bird!


My sister called a little while ago to say that Dad left the hospital this morning -- AMA because he hadn't seen his doctors yet, but the nurses were joking around with him and brought him his wheelchair -- and was eating a good breakfast.

He says he feels pretty good, although he didn't get much sleep. He's probably in better shape than my sister is, at this point.

So as of right now, he's still planning to fly to Sacramento this evening. I hope I have his stamina when I'm 86!

Friday, October 17, 2008

Dad


Dad moved out of his apartment this morning, and is staying with my sister tonight before flying to Sacramento tomorrow. But my sister just called me from her car to say that he's on his way to the hospital because he had a choking fit and may have stopped breathing. He came around when the paramedics gave him oxygen, and seems like himself, but it's still alarming.

And I have no idea what the chances are of his making his flight tomorrow.

Ugh!

Later:

Well, he was determined to leave the hospital tonight, but a very persuasive ER doctor talked him into staying overnight for observation. He was unconscious for a little too long, and they don't know what caused it; the ER doc said that if it happens while he's in the hospital, they can fix it, but if he left, he might not wake up tomorrow morning.

So he's determined to leave tomorrow morning, instead. He's nothing if not stubborn!

Squatter

While cleaning my study, I decided to use a box for miscellaneous-papers-to-be-sorted-later. But, of course, a furry marauder jumped in and claimed it as his own. All boxes rightfully belong to cats. What was I thinking?

Figaro the Elegant

Thursday, October 16, 2008

Knitting Philosophy


My friend Marin, who's a philosopher, sent me a link to the special knitting issue of the American Philosophical Association's Feminism & Philosophy Newsletter.

Too cool!

Driving/Moving Help


I just posted this to our church e-mail list, and also sent it out at work, but I'm posting it here too, in case any Reno readers can help out.

*

Hi, all! As some of you are aware, my elderly disabled dad and his girlfriend (also elderly and not in great shape) are moving here this weekend. On Tuesday 10/21, Gary and I plan to move them into their new apartment with minimal furnishings, as their moving vans won't have arrived yet. We have a bed and some tables and chairs for them, and I'm going to rent a U-Haul van to move the stuff, which won't fit in my car.

Here's the hitch: I'm the only driver in this group (Dad's friend still drives, but I'm not sure I want her driving my car, especially since she needs double cataract surgery). If I leave my car at the U-Haul place, I'll have no way to transport three other adults to the new digs without making multiple trips. So I'd like to ask if anyone can come with me to the U-Haul place, drive my car back to my house when I drive the U-Haul back, and then drive two other people to the new apartment in my car.

At that point, your work should be done, since another friend will be showing up with his truck (hauling a daybed for the new place) and can help us unload.

This should take two or three hours, tops, and we'll be indebted to you for life. (Other payment or bribes of Gary's homecooked food may also be possible.) We'd like to do this in the morning, but can be flexible depending on your schedule.

If anyone's available, please let me know. I know the timing's tricky, since it's a workday.

Thanks!

Susan

Mea Culpa


Yes, I know: I've been terrible!

On Saturday we drive to Sacramento to pick up my father, and on Sunday Fran arrives in Reno. So I've been busy getting ready for that -- and I'm not ready yet, since my study's still a disaster! -- and I've also had a perfect storm of school stuff: I just finished grading my first batch of Women & Lit papers, in addition to 63 papers from the first-year medical-school class (this is on top of my ordinary weekly grading), and on Tuesday I did a short presentation at the med school, pushing our summer Narrative Medicine elective, and then facilitated a Literature & Medicine discussion group at one of the local hospitals.

It's all very satisfying, but I've been busy. Not only haven't I blogged for days, but I haven't knit for days! So you know it's serious!

I'll try to be better from now on, honest. And I hope everyone's well!

Wednesday, October 08, 2008

Meet Myrtle the Turtle!



Heeeeere's Myrtle! That's Janet's foot keeping her from wandering into the shrubberies, and also Janet's voice commenting on her care and feeding.

Turtles aren't slow. Don't believe anyone who tells you they are!

There were various moments when Myrtle, hilariously, came nose-to-nose with assorted dogs (a situation she handled much more calmly than the kitten did), but I didn't manage to get photos or video of any of those. Oh well!

Baby Kitty



This isn't the greatest video in the world, but I hope it will give you some sense of how cute the kitten was. She was in a carrying case to protect her from overcurious dogs.

The Blessing of the Animals


Here's my friend Deb with Emily, her bearded dragon lizard, at the Blessing of the Animals last Sunday. Only five people from our parish came (attendance at morning services had been sparse, too), but we had over twenty people total, and far more animals than that. We'd put an announcement in the paper, and the people who came told me how grateful they were for the service. One man had clipped the notice from the paper and saved it for weeks!

Our church courtyard was a mass of barking, wagging, joyous chaos. I didn't get pictures of all the animals, and many of the ones I did take didn't come out well, but here's another unusual critter: Myrtle the Turtle, one of the turtle tribe proudly maintained by our friends Ned and Janet. I also took a funny video of Myrtle, which I'll post shortly.

Another out-of-the-ordinary critter was this lovely parrot; her person brought another bird as well, along with a dog. None of our parish clergy were available to do the blessing, but the Rev. Jim Edwards, a priest at another parish, kindly stepped in. He did a great job. I was following along behind him, giving out St. Francis collar medals, and he really took time to admire and compliment each animal. He maintained a steady sense of the sacred in the midst of pandemonium, which is what good priests do!

Of course, we also had less unusual animals, like Ned and Janet's sweet, beloved Arnie. (Gary and I catsit for Ned and Janet sometimes, and they return the favor, so we know each other's felines well!)

I've always read that people and their pets grow to look alike, and the maxim's charmingly borne out in this photo. What wonderful hair, all around! I wouldn't mind looking like any of our cats, so I hope the principle's true!

As promised, a representative from the Nevada Humane Society, a terrific woman named Adrienne, attended the service; she brought two volunteers and two adoptable dogs wearing these cute vests, and also a very sweet kitten of whom, unfortunately, I didn't get any good pictures. I took a video of the baby kitty, and I'm not sure how well that turned out, either, but I'll try posting it a little later. Anyhow, the Humane Society rep and volunteers really seemed to enjoy the event. We'd collected $125 in donations for them at church; a number of people wanted to give me money "for your church" to thank us for the service, but I asked them to give the money to the Humane Society, instead.

The HS folks especially loved the St. Francis medals, and promised that when they took the dogs and the kitten back to the shelter, the medals would be pinned next to their cages. "I bet they'll be the next animals to be adopted," Adrienne told me. And sure enough, a few hours after the service, she called me to report jubilantly that Chloe, one of the dogs, had been adopted by a family as soon as they got back to the shelter. Hurrah for the Humane Society! And thanks be to God for Chloe's new family!

I loved the service, as I always do. Throughout the event, I was smiling so much my face hurt; I'm rarely happier than when I'm around animals and their people. At one point, I commented to a church friend who'd brought his two dogs, "This is so much fun!"

He laughed and said, "And it's so you!"

It's so lots of us, apparently. I hope everyone else enjoyed it as much as I did!

Sunday, October 05, 2008

Paying the Rent


Here's today's homily. The Gospel is Matthew 21:33-46.

*

I’ve talked here before about my meandering conversion process, which took decades. My decision to start attending church, though, was made much more quickly, and I made it for one very specific reason: my husband and I had just bought a house.

I’d spent my life entirely in rented apartments, first my parents’ and then my own. As a renter, I was always very aware that the property didn’t belong to me. Renting apartments also brought me into regular contact with neighbors, connecting me --however tenuously at times -- to a community. And the apartments I’d lived in were small.

At 1,700 square feet, our house is small, by Reno standards. But it was far more living space than I’d ever had before, and it sat on a third of an acre. I’d watched people who’d bought houses become defensive and protective of “their property.” Friends who’d once championed civil rights instead started worrying about falling property values, anxious about sharing their schools or neighborhoods with certain other families. I listened to acquaintances talking about “deserving” big, beautiful houses because they worked so hard. All of this troubled me.

Even as I reveled in our newly acquired 1,700 square feet, I also knew that house ownership represented distinct dangers. I didn’t want to forget that I was living with one other adult and three cats in a space that could shelter entire third-world villages. I didn’t want my status as a homeowner to make me afraid of other people, and I didn’t want to forget that no matter how hard I work, there are many people in the world who work much, much harder than I ever will, and who still have to live in substandard housing.

In short, I didn’t want to become complacent. So I started attending church, where, among other things, I learned that Jesus advises us to sell all that we have and give it to the poor. As a new, anxious Christian, I fretted about this over dinner with my husband. “Susan,” he said, “we aren’t going to sell our house and give away the money.”

“But it’s what Jesus would do,” I said, still worried.

It’s also what Saint Francis would do, and we’re observing his feast day today. Francis was born during the late twelfth century to a prosperous cloth merchant, but later renounced his family’s wealth, and even the clothing his father had given him, to embrace voluntary poverty. He delighted so much in the natural world that he is known as the patron saint of animals and the environment. At 3:00 today we’ll be blessing companion animals in his name, and our loose offering this morning will be donated to the Nevada Humane Society.

I love animals, as most of you know, but I’m very, very far from being St. Francis. I give small sums to various charities, but I haven’t sold my house to feed the poor. Nor, frankly, do I plan ever to do so, for which I have to hope that God will forgive me.

The tenants in today’s Gospel, though, are even farther than I am from the Franciscan ideal. The parable we heard this morning is a cautionary tale about greed, entitlement, and complacency. God has granted humans stewardship of his creation, a glorious vineyard full of all good things. We have been entrusted with the responsibility of caring for this creation, for “paying our rent” by ensuring that land, water and sky remain healthy and productive.

Some of us have managed to remember that we don’t, in fact, own the planet, that it isn’t ours to do with as we please. Others, though, have become greedy and complacent. Possession is nine-tenths of the law, you can hear them argue, and if the landlord’s agents only show up once a year and do none of the work, why should they receive any of the yield? Why should the tenants share the results of their own hard work with anyone else?

In the parable, the landowner’s slaves are clearly the prophets who have warned God’s people to follow God’s law, and the landowner’s son is clearly Jesus, stoned and crucified. The lesson here isn’t at all subtle: unless we both care responsibly for God’s creation and give back to God what is due Him, we will, much sooner than we’d like, be evicted.

This may be a painful analogy to use at a time of widespread foreclosures, when so many families are losing homes. The current grim economy illustrates, among other things, that various institutions and individuals have not done a good job of managing their resources, of stewarding the treasure with which they’ve been entrusted. Embracing involuntary poverty isn’t a saintly act: it’s a symptom of social injustice. Neither Jesus nor St. Francis would approve.

How do we keep from being bad tenants, from taking God’s creation for granted? How do we keep from becoming complacent? How do we remind ourselves to pay the rent? The first step, I think, is to remember that we do not have an absentee landlord. Our faith calls us to see the face of Christ in everyone around us, even those whose presence in our neighborhood makes us nervous. Our faith also calls us to remember that nothing we claim to “own” is truly ours. Everything we have comes from God. We have done nothing to “deserve” the grace of God’s love, mercy, and generosity, to deserve the earth we stand upon, the water we drink, or the air we breathe. We obey God’s commandments not to earn God’s love, but to thank him for the love we have already received. And God commands us to love our neighbors.

If we’re looking for examples of loving our neighbors, we could do worse than to watch the animals St. Francis loved. My friend Mary loves to tell the story of her favorite dog, a collie named Blaze. Mary lived on a farm in Massachusetts, surrounded by other farms. Every day at 4:00 PM, Blaze left the house, returning promptly at 5:00. Her neighbors told her that he made the rounds of neighboring farms, stopping briefly at each one to make sure that everything was all right. One day, Blaze started coming home at 5:15. Curious, Mary called the other farms on the route to find out what was going on. “Our dog just died,” one of her neighbors said, “and our little boy is devastated. Blaze has been playing with him for fifteen minutes every day.”

A few weeks later, Blaze started coming home at 5:00 again, and Mary called her neighbor. “We just got a new puppy,” the other woman said, “so Blaze knows he doesn’t have to spend time here anymore.”

My friend’s dog didn’t limit his love and loyalty to his own household: he expanded his definition of “home” to include everyone he knew. He acted as a conscientious steward, both taking care of someone who needed him and knowing when his attentions were no longer necessary. Rather than avoiding a farm where another dog had died, he stepped in to help.

My friend’s collie took care of a little boy who temporarily had no dog of his own. The Humane Society takes care of animals who, we hope temporarily, have no people of their own. By donating to the Humane Society, we will help them care for these beloved creatures until other humans claim them. But let us remember that the Feast of St. Francis isn’t just about the domesticated animals so many of us love. Francis reminds us to renew our care and commitment to all of God’s creation: to all plants and animals, to air and water and earth, sky and sea and land. Francis reminds us to praise and bless the Creator who has given us these gifts, and -- even if we do not plan to sell our houses or give away our clothing -- to ask always how much we really need ourselves, and how much we can give to others.

Amen.

Saturday, October 04, 2008

Chair Share

The cats can't say we don't accommodate them!

Friday, October 03, 2008

Zombies and Politics


John Joseph Adams has posted the entire text of my story Beautiful Stuff. Just in time for the election, too.

Funny, that.

Thursday, October 02, 2008

Milestones


As of today:

I've knit every day but one for the past year. (The one day I didn't knit was a day when I was so busy that I realized only as I was falling asleep that I hadn't knit that day. There were other days, although not many, when I didn't feel like knitting -- usually because I was sick -- but on those days, I made myself knit at least one row.)

I've volunteered 700 hours, spread over four years, at the hospital. Ironically, this week I got my 500-hour pin, given out at an awards luncheon last month I was unable to attend. After 500 hours, you don't get another pin until 1,000 hours. There are people who've served over 7,000 hours, and who've been volunteering for over thirty years. Wow!

My own modest milestones aren't heroic achievements, but they make me happy. Also, this morning I tracked down some medical care Fran will need when she gets here and made an appointment for her. When I called her to let her know about the appointment, she said, laughing, "If you ever need a kidney, I'm your gal."

I certainly hope it won't come to that!

Wednesday, October 01, 2008

Autumn Gold

Happy October, everybody! This is my favorite month.