Saturday, May 9, 2015

Reflections

I'm really happy about all of the positive feedback I've received from my family  about the "Outlaws" post.  There are other stories I'd like to share, including from my maternal side of the family but I need a little time to  decompress  from the emotions I put into that post. One of my cousins  wonders if several of us could somehow put our memories together. That would be  a fun project, but how to do it? I read my post & the many facebook comments about the post aloud to my mom this afternoon. She enjoyed remembering & the nice compliments about how cool, thoughtful & funny my cousins think she is. She will absolutely never forget the Waldorf episode when the cousins locked themselves  in a room with open windows. Do any hotel rooms actually have windows that open these days? I think the windows were open at the Waldorf  that day cause we were  feeding pigeons on the little  ledge outside the window. I'm surprised  they weren't flying around inside the room. Next time I write family memories I have to include  the week my family stayed at the Beverly Hills Hotel. We were there for David's medical school graduation.  My dad would never have paid for that expensive a hotel but we were compted for some reason. I wish some of my cousins had been there to enjoy a fairy tale stay at the Hotel California. My other most fun memory of being in a famous establishment was when we went to the Russian Tea Room  when we were in NYC for Laura's wedding.

On a completely  different  subject yesterday I went to a  gym.
 I've actually never been to a real gym before. I've done aerobics classes ( the reason  I can't stand Hall & Oates to this day). I've tried yoga a few different times. I went for a while to a "rehab" gym in the '90's after a lot of Physical Therapy on a previous back issue. Just before I found out I should not be climbing hills cause of some spinal problems ( compression fractures, a healing fracure in my sacrum & a pinched nerve) I was attempting to try getting in shape by walking my street which is a steep hill. I was making it twice around our looping street in about 30 min but with every step uphill I could feel my back.The PT's I'm seeing now said it would be OK to do the treadmill if it was flat & the recumbent bike. I was really sweating. Sometimes I get somewhat compulsive & I may have gotten carried away.  I also got down on a mat & tried some of my PT exercises.  While I'm still in PT, I'll probably only be able to get there once a week, but I'm so glad I got started. Besides the sweat my biggest challenge was  figuring out the dashboards on both pieces of equipment. My writing idol, Nora Ephron said that every time she got into shape, something broke. Having had the following in the  last 2  1/2 years I can relate: broken arm, rectal cancer, radiation therapy, 2  kinds of chemotherapy, 3surgeries, a kidney stone, a heart problem. Oh, I forgot the broken ankle.

I just realized something strange. I have a full plate of stress inducing realities right now but I may be happier than any day except when I gave birth. WHY? I am making my way through it. I survived 2 years of hellish cancer treatment all the while taking care of my mother. I wasn't always graceful. I cried in doctors  offices all over Tucson. I had to deal with a one incompetent  doctor who was trying to dictate what my surgeon should do with me & my first therapist lasted one session. She thought I was feeling sorry for myself. She needs to go work in a drug treatment program. I was not a candidate for tough love in the middle of my cancer treatment.






Thursday, April 30, 2015

The Outlaws

When I was a very small girl,I became acquainted with the term "outlaws".  My Uncle Artie coined the term to refer to the men & women who married into the Siegel family. He told my mom that they weren't  inlaws, but outlaws. The Siegel family was large so there were lots of outlaws &cousins. My Siegel grandfather &his brother married my Siegel grandmother &her sister( a lot like twins marrying twins) so all of us were proficient at figuring out who was a first,second,once  removed etc cousin. Unfortunately I never had the pleasure of knowing my Siegel grandmother as she died suddenly at a tragically young age. My grandfather remarried. Her name was Fan.  She was an outlaw I guess but I knew very little about her. I assume she is the one who oversaw the huge spreads of food when the family gathered in their house at 205 Church Street. There were tables laden with everyone's favorite foods.  Along with the various varieties of fish,bagels &  salads there was always some Rice Krispies for my sister.

We used to have family reunions while my grandfather was still alive. They were held in a park in Lancaster,Pennsylvania around the time of my grandfather's birthday in June. They were large gatherings with many active children running  around. I remember barbecues but I don't remember  anyone in the family who  could do that. It must have been catered. Some of the cousins  have talked in recent years about resurrecting the reunion, that would be much fun. Some of my cousins I have not seen in 10 years. This is my fault I know for living in Arizona and  not Massachusettes,NewYok,New Jersey, Maryland Pennsylvania or Virginia.

Unclet Artie as I  said coined the term outlaw, so he will be  the first I talk about. He was so funny,loving and he genuinely liked other people especially children. He always had something funny to say.  He never lost his Brooklyn accent so the jokes always sounded funnier because of his delivery. He danced with all of the little girls at weddings& Bar Mitzvahs. He let us put our feet  on top of his shoes while we danced. He had a nickname for me. I was "Pammy from Miami". ( I wasn't but it rhymed & it was funny  so I loved it). Uncle Artie worked at the Pentagon.  We always wanted him to tell us what he did there. Some of us were convinced  he was a secret agent of some kind.  When he explained what he did it never made any  sense. I was sure he was under orders not to tell anyone about his top  secret job. I still don't know  what  he did  Maybe someday his kids will tell me.

At least one of the outlaws came with a partner & that would  be Aunt Maureen.  Aunt Maureen was beautiful (inside and out) & vivacious.  To make her entrance into our family even more exciting, she brought her parents with her. I apologize that my memories of her dad are fuzzy, but I think he was the pet wrangler in that family. Àunt Maureen's mother was a force of nature. She too was beautiful.  Her name was Aunt Reggie. She was exotic (at least to me). She had a British accent.  She taught us how to get the best suntans (while it was still OK to get suntans). The secret was to mix  iodine & baby  oil, slather yourself up & then sit  with a reflector aimed at your face. Both Aunt Maureen & Aunt Reggie were born to be married.  They were also never say die matchmakers. They were always dressed impeccably( they also offered fashion advice). I remember Aunt Maureen &Uncle Charles stopping by our house in Illinois on their way back from their honeymoon. They were a lesson in newlywed  romance. You could see the love in the air. If any of my cousins have a picture of their wedding party, I was a flower girl. I had to stand still for the longest time during the ceremony & I was gently reprimanded by my mother  afterwards because I had been sliding  my foot back & forth. I have a bracelet  that was a gift to me for being in the wedding  that I still treasure & wear. I'm pretty sure it was before Uncle Charles & Aunt Maureen's wedding that the infamous "locked door freak out"of my mom occurred at-- I think it was the Waldorf in NYC. We had connecting rooms. One of us cousins locked the connecting door leaving  a bunch of us kids alone  in an upper story room with wide open windows. I dont know how we got out, but no one fell out the window. I was honored to be present when Aunt Maureen  remarried after being widowed,  it was a beautiful wedding in her Japanese garden. I'm so glad Morris Tischler made her happy.

Unfortunately, Uncle Peter is a far away memory, but certain things are imprinted in my brain. He was kind, warm & soft-spoken. I remember loving him so much it hurt. He & my Aunt Anne brought me a native American doll from Oklahoma. Uncle Peter was a physician with, I'm not sure what it was called  then, but something along the lines of "Indian health Services". Maybe one of the Ball children can let me know what it was called. He left us much too soon.

If Aunt Maureen came with a partner, then Patricia came with a whole posse.  Patricia married my youngest Uncle, so she is only about 10 years older than me.  She felt too young to be an Aunt& really wanted to just be called Patricia, but I could never do that. These days skipping the "Aunt" has been easier.  She was (and is) beautiful & sophisticated. I looked up to her. She brought along her parents, sister, a few cousins& the most glamorous aunts ever.  They were all gorgeous & very well put together. The Siegel family definitely needed their infusion of (I hate the word, but...) CLASS. Patricia & Uncle Stanley took me along to an outstanding cultural experience(Mikhaiĺ Baryshnikov). Sorry to report that no matter how impressed and excited I was, I could barely stay awake  due to some late night  teen shenanigans the previous night.  I don't even remember what the shenanigans had been. By the way Patricia heard of Ravi Shankar before I did.

Aunt Selma was mysterious to me. First of all she never seemed to age. I had a couple of firsts at her house. One of those things was caviar. Oh my goodness, I've been addicted ever since. Aunt Selma also offered fashion advice. I was slow to find my style. I think I needed all the advice I could get. I remember show tunes always being on the stereo. I've been  addicted  to  those  ever since also.

I have one last Siegel outlaw & that was my Uncle Myer Nathan. He was a quiet sweet man. Maybe he wasn't always quiet. Maybe it  was just when he was surrounded by Siegels. He had a lot of extra family responsibilities due to my Aunt's poor health. From my vantage point he did a fantastic job. I know his children loved him very much.

I had one outlaw on my mother's side of the  family. Uncle Bob was a character, not a laugh out loud character, but just very unique. He was an entomologist & taught at St Lawrence University. He had no patience with us kids who were afraid of "bugs". He had a very distinctive  voice. I can still hear it. I wish I could see his reaction to a local business here in Tucson   "Uncle  Bob's Popcorn".

I know some of these memories may be &probably are romanticized a little. Unless I made an outright  mistake I ask my cousins to let me keep my fantasies. I also know that everything wasn't always "hunky dory". I know not everyone always got along, but I also know everyone loved one another. I left out someone's 2nd marriage cause it didn't work out & I figure that's not my busines to write about .

Thanks got to Uncle Artie for the outlaws joke. It stuck in my mind all of these years &gave me the idea for this post.

Addendum: My cousin Ellen messaged me on Facebook this morning. She said she liked this post &ŕeminded me that Aunt Reggie's husband's  name was David Hayman. She also said it was OK to talk about her stepfather Ralph Klein. Yes, for a while at least my aunt's name was Anne Klein. Ellen told me that Pat(Patricia) used to refer to "Ralph Klein time" as opposed to Siegel time. Ralph liked to stick to the schedule like my dad did.  They were prompt/ready to leave at the time they said they were leaving. The Siegels had famously long goodbyes which always put us behind scedule. Thank you Ellen.

Tuesday, April 28, 2015

WE DON'T LIVE IN OREGON (caregiving part umpteen and a half)

Interesting to read my last post again. The interim has been almost chaotic. My mother has had an infection that required her to be admitted to the hospital for IV  antibiotics . She then went to rehab for 2 weeks to try to regain her strength. She is now home and healthy though not yet back to her strength and  abilities she had before this infection started.  Looking back I  realize this had probably  been going on for at least 6-8 weeks. She is now receiving home  heath.  There are  therapists, nurses  &  aides  coming  &  going. I  am  grateful  for  the  help. It won't  last  forever, but  I  will  try  to  make  the  most  of  it  now.

The day  my  mom  went  to  the  hospital  was  Friday  April  3. Her condition  deteriorated  throughout  the  day. I  was  in  touch  with  her  Primary  Care  Provider  who  was  less  than  helpful. I've  blogged  before  how  dismissively  they  have  responded  to  my  concerns, suggestions &questions. I had  had  it  with  the  symbolic  condescending  pats  on  the  head they  gave  me. However  I  thought we had  finally  come  to  an  agreement  to  respect  one  another's  voice. WRONG . I  was  trying  to  prepare  for  the  first  Passover  Seder  that  night  while  monitoring  &  helping  my  mom. Thank  goodness  for  the  wonderful  Charlotte  who was here  to  help  for  part  of  the  day. I  won't  detail  the  phone  calls  back  &  forth  with  the  PCP  at  this  time ,  but  the  gist  of  the  message  I  got  was  that  I  was  overreacting. She  almost ,  but  not  quite  told  me  to  give  her  2  aspirin  &  call  her  in  the  morning. Just  before  the  third  cup  of  wine at the Seder I  called  the  home  health  nurse  for  advice. She told me  to  take  her  to  the  emergency  room. The  rest  of  the  family  agreed  &  I  called  an  ambulance.  The  severity  of  what  was  wrong  assured  me  we  had  done  the  right  thing. The  PCP  called  me  the  next  day  to  see  how  my  mom  was. I  told  her  she  was  in  the  hospital. She  seemed  genuinely  shocked, but  of  course  offered  no  apologies. (I think  lawyers  must  teach  a  class  to  them  titled  "  Never  Aologize").

The  reason  I  am  blogging  on  this  subject  is  that  this  is  instead  of  an  angry  letter  to  the  PCP.  I  don't  have  to  worry  about  saying  it  just  right, I  can  just  express  myself  without  endless  drafts  of  a  letter  I  would  probably  never  send. I was  ready  to  fire  the  PCP, I just hadn't  made  a  final  decision. On  the  15th  I  received  a  letter  from  the  PCP  firing  my  MOTHER  as  a  patient. I was angry but  not  entirely  surprised. Frankly  what  made  me  the  angriest  was  that  she  had  kicked  us  to  the  curb  before  I  had  a  chance  to  do  it  to  her. What  can  I  say?  One  of  my  least  attractive  traits  is  that  I  don't  forgive  or  forget.

Her  letter  to  me  looked  like  it  had  been  written  by  an  attorney. (I really  have  nothing  against  attorneys, but  realize  this  is  my  second  snarky  remark  about  them). It  said  they  were  giving  us  thirty  days  notice  because  they  could  not  meet  the  family's  expectations. Damn  straight! This was the most honest thing she ever said.  My  expectations  include  listening  to  me  as  much  as  I  listened  to  them. I  expect  that  they  respect  my  religious  /  spiritual  beliefs. I  expect  that my mother  be  treated  no  matter her age. I  expect  infections  to  be  carefully  treated. I  expect  not to  be  subjected  to  hockum  about  weird  diet  fads & their  proselytizing  about  Oregon's  assisted  suicide  law. My  mother  has  been  seeing  this  PCP  &  her  nurse  for  about  six  years. The  first  time  the  nurse  came  to  our  house  she  said  my  mom  was  on her"way out". I expect  them  to  respect  my  requests  that  we  not  talk  about  death  in  our house. My  mom  wants  to  live. She  has  said  it  over  &  over & may  she  live  for  a  long  time  to  come. I  expect  them  to  know  that  a  medication  should  be  discontinued  because  of  certain  lab  results. I expect  an honest  recounting  of  recent  health problems  my mother has had. (A hospitalization  3  years  ago  was a result  of  my mom's sodium  getting  to  a  dangerously  low  level  while  under  the  PCP's  watch. The  PCP  continually  refers  to  that  hospitalization  as  being  because  my  mom  was  constipated-She was  but  that's  not  why  she  was  admitted  to  the  hospital). Why did  I  put  up  with  this  nonsense ?  My  mom  liked  her  &  I  thought  by  being  vigilant  I  could  keep  the  PCP & her  nurse  on  top  of  things. All  I  did  was  irritate  them.

I'm  not  considering  it  now  but  if  I  ever  do  decide  to  sue  them, it may be for  religious  discrimination  as  much  as  malpractice. Jews just don't talk  about  death  especially  in  front  of  the  patient. They  questioned  me  frequently  about  my  Healthcare  power  of  attorney  &  advance  directives.  I  told  them  repeatedly  that  the I WAS my mom's POA,presented  proof  &  more  than  once  explained to  them  my mom tore up her advance directives  over  10  years  ago  after  she  saw  the  effect  they  had  on  us  as  a  family  during  my  dad's  final  illness. They  didn't  seem  to  understand  the  difference  between  a  power  of  attorney  &  advance  directives. We didn't  fit  the  cookie  cutter  mold  of  their  expectations.

I would be less than honest if  I  did  not  mention  that  I  made  a  huge  mistake  with  these  providers  by  letting  professional/personal  boundaries  disappear  because  for  a  while  I  thought  they  were our friends. When  you  are  greeted  with  a  hug, sometimes  your good sense  goes  out  the  window. I won't  cross  that  line  again.

By  the  way, I  had  a  new  excellent  doctor  for  my  mom  within  48  hours. When  I  talked  to  their intake person, I was open what had happened with the  previous  provider. I  expressed  my  philosophy & was  assured  that  it  was  their  philosophy  too.

One last jab at  this (I almost said crackpot but  that  would be wrong wouldn't  it?) woman  is that I  think  the  attorneys  didn't  tell  her  to  never  leave  an  angry, incoherent  voicemail. I'm  never  erasing  it.

Tuesday, March 10, 2015

Who's the Boss? Caregiving Part Umpteen

Someone I trust (even tho I haven't seen her in a couple of years) told me "They work for you, not the other way around" (referring to doctors, nurses, home health aides, etc, etc....).  People have been telling me this for the last eleven years when I first helped my mom coordinate care for my father (of blessed memory).  First we cared for my him, then for my sister (of blessed memory) & now I am caring for my mom.  I am sometimes a slow learner, but this particular lesson (that I am in charge, not all of the holders of the jobs mentioned above) has been imprinted on my brain finally, I hope.  I am stronger & more capable of standing up for what I believe my mom needs.  I realize I'm not an expert in their fields & will of course listen to them, but I am the boss, I am my mom's advocate.  I will fight for her right to be as independent as she can for as long as she can be.  I am tired of being "patted on the head" & mocked as some kind of obsessive- refusing to face reality- daughter.  They need to recognize OUR reality, OUR goals & OUR beliefs.  I think I might write it up & make it required reading for anyone coming into our home to help us.

Last night, I called the old friend mentioned in this post's first sentence & asked for free professional advice.  She offered some suggestions within her practice guidelines(friend or not, a professional cannot offer advice without actually seeing the problem).  I called her because my mom was going to have to wait 2 weeks for this kind of official appointment. The PCP wanted to wait until some other test results came in.  I understand the theory of this.  It's good medicine, although my suspicious nature told me it was being denied because they thought I was not facing "reality" &/or expecting too much. There is also need to suss out problems of cognition vs problems of strength.  I don't want my mom getting weaker because I expect too little of her, on the other hand I don't want to endanger her because I am expecting too much of her. I won't go into detail in this post about the problem, but it involves the bathroom.  I said that if we could not get help for 2 weeks, then the bathroom was going to be completely unsafe & dysfunctional in the interim.  The nurse said, in that case, she would come look at the problem today.  I appreciated that but it wasn't good enough.  I cannot describe how dangerous & upsetting the situation is/was.  I called my friend & told her the problem.  We talked a long time.  She said she agreed with the PCP about waiting for the test results but understood my frustration.  She offered a suggestion.  I immediately put it into effect & guess what?  It works!!!!! No more crying or arguing from either my mom or me.  Also, a lot less stress.  I wish I had insisted on this type of consult several weeks ago.  Instead I was left on my own & the PCP/Nurse suggestions.  This lead to a wasted $110 fix that didn't work.  You of course cannot return used bathroom items.
I am so happy right now that every trip to the bathroom does not need to be feared by either my mom or me! 
 

Saturday, March 7, 2015

Potpourri

Several things are going on...
My mother's strength & ability to stay focused in reality are declining rapidly.  I have written about my mother before.  (The D word, Lost in Translation, & A Cup of Tea) I feel like I am betraying her by writing about how she is doing.  It's private, but I need to write.  It is my way of trying to make sense of the incomprehensible.  Let's just say that I remember my great grandmother in her final years.  She "saw" & "heard" things that were not there.  She was not always cooperative.  She didn't communicate much.  She needed help from my grandmother in the bathroom.  She was strong though.  She walked around the house without a problem.  My mom is having trouble even getting around with the walker.  We have the wheelchair easily available now, because some times she needs it.  She is capable of far more than she attempts.  "I can't" is her favorite expression.  If I walk away, she can do more than if I stand there & tell her she can do it. It's hard to decide though.  I don't want her in danger, but sometimes if she says "I'm going to fall" it sounds to me more like a threat than a prediction.  When I think about what I used to worry about with her, I would give anything to go back to those problems rather than the ones we have today.  Will the current problems sometime in the future look "easy" or "mild"? I have been alone with my mom for almost 48 hours, save for an hour when the nurse practitioner came to see her yesterday.  I have some relief coming in the morning for a few hours.  What I look forward to the most is conversing.  When I am away from home or if I'm able to talk on the phone after my mom is in bed, I chat & chat & chat..... I strike up conversations with almost everyone I see.  Now I sound like I am whining. This is happening to my mother, not to me.  I have so much to be grateful for.  I need to count my blessings.

I am finding it hard to interject any humor, even my dark, sarcastic humor into this. I titled this post Potpourri because I intended to discuss other things that are going on.  Thursday night the world lost a lovely inspirational woman at the tender age of about 57.  I only knew her for a year but will never forget her serene demeanor in the face of an awful illness.  Someday I hope to find what it takes to be at peace with a bad situation even while fighting against it.  Tomorrow morning I am going to a group meeting where I met this lovely lady.  The mood will be sad.  Unbelievably, the set topic of the presentation & discussion will be friendship which has been planned for a long time. 
We should all just breathe.......& try to be present for ourselves & one another. 

Thursday, January 1, 2015

A Cup of Tea (Trakht Gut Vet Zein Gut)

My mom has a nurse who has been coming to see her here at home for about the past 5 years.  I like her very much, but she has one habit that has bothered me.  Many health care professionals feel the need to force the patient & family to "face reality".  It's gotten to the point with this one nurse that I irritate her by interrupting her little speeches.  She tried again the other day.  She wanted to talk to me alone before we went in my mom's room.  I thought "uh oh".  We sat down, she leaned forward, looked me in the eye & said "Pam, you know your mother is a very old woman...".  I waited for her to take a short pause before I interrupted her again & said "Just because I don't want to talk about it doesn't mean I don't know it".  I went on to use about 3 metaphors such as "I may appear to have my head in the sand but I don't.  I just don't want to talk about it"..I think she finally understood!!!! We shook hands.  My mom hasn't been out of the house for 2 1/2 years.  The only place I want my mom to go is to the emergency room if an emergency happens.  We are not going to go to any specialist's offices. S/he would just want to order a bunch of tests which would mean more trips out which would drive my mom crazy & wear her out.  The nurse practitioner & RN will continue to see my mom here at home & try to manage her care & medications.  We are lucky that there is a lab that comes to the house so that my mom's blood can be tested every few weeks to see if her medications or diet need to be adjusted.  In other words, just because my mom is a "very old woman" does not mean we don't want vigilant care.  Infections will get treated, fluid imbalances will be addressed & things that can be fixed or improved will be.  This nurse wasn't suggesting we ignore my mom, but the message I was getting from her was that she thought I was living in "la la land". (Even if I wasn't facing "reality" I still don't understand this need from medical professionals to beat you over the head with it).  I believe in the old Yiddish expression "Think good & it will be good" "Trakht gut vet zein gut". Our home will remain a place to talk about what is going right, what is good, what is optimistic.  Words & attitudes affect one's surroundings.

The very day after the nurse visited, I went out for one of my doctor's appointments.  My mom was home with our most excellent caregiver Charlotte.  When I left it was cloudy & ready to drizzle.  When I got home, it was 40 degrees F & pouring rain.  Charlotte had a cup of tea waiting for me because my mom had ASKED her to make it as I would be cold when I came home.  My mom had told her to be sure not to make black tea, because I'm not allowed to drink that.  She is correct. I am not allowed to drink black tea.  Pretty good for a "very old woman" !


Texting Etiquette

Not long ago I was invited, via text message, to an important event just 3 days away.  I was offended! Maybe you wouldn't be, but I was.  As readers will know, I need to arrange caregiving for my 88 year old mother whenever I am planning to be out of the house.  I can not leave her alone.   I stewed about this  invitation for a while, trying to figure out if I could make arrangements on such short notice.  I was also annoyed at being invited at the last moment & not even with a phone call, but with a text message.  I thought how to respond to this invitation for a few hours.  Apparently, this was not fast enough, because the person who had invited me telephoned to find out if I had received the text message! Why not call me in the first place? Why not call me a week ago?  Maybe I should save this righteous indignation for more important things, but I am not the person who could do that.  I did manage to make arrangements so that I could attend, but apparently it's still bugging me! Ha!

Again not long ago, I saw a post on Facebook that someone who was a friend of a friend had passed away the previous night. This of course was sad, but the problem was not all of the family had yet been notified!  Subsequent comments indicated that some of his relatives found out about the death on Facebook. Tragic. I think if we hear of a death, we should keep our fingers off the keys & make a phone call, an old fashioned telephone call.  I appreciate the irony that someone who is blogging details of her life would object to people sharing too much on Facebook, but this is my choice & my life. 
I know a few people who don't like congratulations, happy birthdays, invitations, etc issued online.  They want phone calls or greeting cards.  Yes, I know a wonderful woman who has a full collection of greeting cards & sends them out for holidays & birthdays.  They are a treat to receive.  "Snail" mail has its positive side.  It's fun to open the mail box & find something other than a bill or junk mail.  It's touching that someone took the time to personally reach out to you.  I am not that motivated to send out cards like my friend does, but she likes me anyway.