On becoming a 'parent' to one's parents

On Saturday, two days time, I go to Virginia yet again to accompany my father through a surgery.  

We hired a caregiver for my dad last time I was there, in late October. It was a wonderfully strategic hire - now someone checks in on him and helps him remember his appointments. She assists with the legal stuff the family is trying to get done. She accompanies him to doctor's appointments. On the down side, now we know a little more just how bad is confusion and memory are. We can no longer ignore it. Clearly Dad needs help.

What to do, though? He insists on staying in Charlottesville, near no one in the family. He doesn't have friends and he doesn't belong to anything with strong social ties like a church, a club, or a senior center. He goes out and does things from time to time, but always alone.

If he moves to assisted living, his freedom will be curtailed. If he can't come and go as he pleases, then what is the benefit of staying in Charlottesville?

I am not eager for him to move here, though. My sister and brother are not keen on him moving to their home towns, either. I think any of us would step up if he stated a preference, but he does not. If he stays in Charlottesville in assisted living, none of us would see him very often. What would be the draw? No house, no place to stay for free, nothing to do with Dad, and eventually Dad will likely stop knowing who we are, so no meaningful connection.

Not that there's much of a meaningful connection now, while he still knows us.

I'm sure we'd all go see him out of obligation once in a long while. We could not be counted on for his care, entertainment, or emotional support, though. We could hire people.

It's all so sad.

There is the chance that this procedure will improve his memory and function, but I'm not holding my breath. Even if it does, though, it's merely delaying what's coming.  

One step at a time, I guess.

Hurt by Life

I have re read When Bad Things Happen to Good People. After 9/11 in the United States, this book helped me come to grips with the senselessness of the terrorist attack and the death of so many innocent people. It did help.

This time, I picked it up because someone I work with was shot and killed in the parking lot of one of the buildings where I work. He was a good guy and didn't deserve this. His family didn't deserve to lose a Dad, husband, and son. Worse yet, his brother killed him and then completed the theme of our time: the murder-suicide.  The family had (and still has to) deal with losing two sons.  My coworker was in his early 50s and he and his wife had recently adopted a child from China. He was a stable, upstanding, smart and clever person

In this situation, I don't know what our society could have done differently. The brother had a known history of mental illness and until recently, he had fairly successfully managed it. Then, for some reason, he stopped taking his medications. He started making threats.

The family engaged the police and got restraining orders. My coworker alerted his team to keep an eye out for a stranger in the parking lot.  But in a situation like this, in our free society there's only so much you can do: the brother was able to get a gun, he identified a vulnerable time to stalk his victim in the parking lot (early morning), and he was determined to kill my coworker. He found a way, and he did it.

A great loss. Greater than I can even know.

I did not work closely with the victim so I am dealing with it fairly well. At least one person who worked in partnership with him has had a very difficult time.

Now, I feel like I need to re-re-read the book. I find myself in a difficult season of life, and I don't know how far I am through it or how deep it is - will it get worse? Will it be over soon or years from now?

While I was working the hospital unit, like most nurses, I developed a perspective or a philosophy about life and the human condition. Life here is really hard. We all do the best we can with the tools we have and sometimes things get all twisted and confused.


My 16-year-old niece is pregnant. I just found out last night.

Now, usually, I'm rather casual about these things. It happens all the time and nowadays, in certain social groups, this is pretty normal. In fact, it's almost expected. You get pregnant in high school, have your child, your parents raise it with you and help support you while you work a low-paying job and go to community college. Then you get married and create a blended family, and have a few more kids. Then you divorce and start the divorce-remarry-blended family cycle. Blah blah blah.

stock photo: not my niece!

You have dramatic, engaging stories to tell with you as the hero (or the victim) later in life. "Oh, woe is me," or "if only I'd known then what I know now!!" And you swear...you swear!... you want better for your kids!

Then your kids do the same thing, because really... this is all "OK." Since it's so normal today, there aren't social consequences in the same way they were 40 years ago. It doesn't ruin your life...it makes your life unnecessarily difficult, but we have changed our society to accept it, sometimes begrudgingly.  In fact, those who judge or reject girls with babies are uncool, old fashioned, and definitely the minority. For those who do not think it's OK, the best we can do today is begrudgingly accept it.

I mean, the pregnant teenager meme all over TV, media, and movies. Pregnancy brings so many exciting things! Presents! Attention of my friends and family! Drama! Excuses! See how excited everyone gets when a duchess or a movie star becomes pregnant! Why wouldn't young people think this is a good way to conduct their lives?

Sigh.

Abortion is socially just not an option these days. ...well-played, far right conservatives. It took 40 years, but yes, well-played.

I don't know what to do, if anything. I would like to communicate with her that I don't condone what has happened and I don't know how to do that from a distance. I don't want to cut her off, really, since our family is small.

I want to reach out to my brother and sister in law, but I don't know how. I really feel for them. They try so hard.... but something didn't work as intended. Nobody knows why - they are good people and they try to do the right thing. Yet, just like me, they are human with faults and flaws, confusion and misdirections. They have been hurt by life, too - here, now and in the past. This all factors in.

I don't want this to devastate them. I fear it could collapse their marriage.

Would it be too preachy to send them a copy of this book?  Should I leave them alone because they don't need one more person to be all up in their business? Crap, I don't know.

Harold Kushner says that showing up and being-with is one of the most compassionate things we can do. Maybe that's where I start.

Argh!

Every time I bring out my serger, I break it. I finally had a nice little project to use it on - making polar fleece caps for church for donation. I can even use up my extra polar fleece pieces!

It took about 45 minutes to change the thread and get the tension set right to make a nice stitch. I was feeling pretty good about it. I figured out what was wrong with the stitch and adjusted it. Hey, I think I'm getting it!

And then,

A dang pin got too close, got stuck under the blade, and now the serger is making funny noises and won't stitch at all. I think I either broke a gear or stretched a belt.

I swear. Maybe I'm not destined to make projects with a serger. This is ridiculous!

Off to the Bernina store again.

Trixie

Now that we've had Trixie for about a month, she's settling in to our routine. I have seen her stand next to purebred dachshunds. She's not a purebred dachshund. Her head is too round, eyes to round, snout too perky. My current theory is that she's a Chiweenie - chihuahua/dachshund mix. She and Winnie are getting along well and they enjoy one or two wrestling sessions a day.

Trixie hasn't quite figured out the connection to peeing and pooping and the door. She's a sneaky little dog, so we haven't been able to catch her in the act. Catching them as they are eliminating usually teaches them the best - they know exactly what you're upset about, and hopefully you can establish new associations with the outdoors.

She likes to ride in the car, but she is a menace to drive with. She wants to be in your lap while you drive with her front paws resting on your left arm to steady her as she looks out the driver's window. Yeah, no, that is not going to work. We will probably try to find her a booster seat that will confine her, yet let her look out the window. We put are smaller crate in the cargo area of  the car for her to travel in and her whining was just so pathetic.

It is so fun to have a new, adorable, and playful pup for a change.

The Circle of Life

Today is the Thoughtful Quilter's 5th anniversary. Five Years! I'm a senior citizen in the blogging world!

Life sometimes gets in the way when you're busy making other plans. My father's situation is worse and I have had to focus energy on taking over. I became involved in a political campaign for a candidate for House of Representatives in Kansas (state level) and I built a website for him. I maintain a Facebook page for the campaign also. I led a project to grow vegetables in a community garden 100% donated to a local food pantry for local hungry people.

I posted about Riley. Through all of this I've suffered many a day with uncomfortable and maddening perimenopause symptoms.

It's not all bad....I attended a 1-day workshop with Denyse Schmidt, a nationally known art quilter. I took a mini vacation in southern Kansas and southwest Missouri, seeing national parks and Laura Ingalls Wilder sites. We got a new car! It's a 2012 Prius with all kinds of bells and whistles...and Lord Almighty, it's red!

Starting New

What a gift to start something new, to begin. I appreciate having something to be excited about. And here she is!

Introducing Trixie! She's our new pup - she's a mini dachshund (possibly purebred) adopted from the Great Plains SPCA. She has some issues so they kept her separate from the other dogs - that's why she wasn't adopted right away. Little dogs tend to find homes fast, they say. She had been at the shelter for about 1 month.

She's slowly coming out of her shell and I think this week she finally decided we're OK. She is about 18 months old. She likes to play and snuggle and give kisses. And she's tiny - maybe 10 pounds! I wanted a little dog again, but this is really, really tiny.

She and Winnie are working out their relationship. I don't think there will be a fight, and I hope not, because Winnie could really hurt Trixie if she wanted to. They have started to play in the house and there's a lot of nipping and play biting.

Trixie has been very shy, especially around my husband. She finds refuge in her crate and she's perfectly content to stay in the crate all day. We think she must have been a puppy mill dog - she has had puppies at least once.

We are looking for a school for basic obedience for her. Taking your dog to obedience school is one of the best things you can do for yourself and your dog. You learn how to be a leader for your dog and the dog learns some basic commands that boosts his or her confidence. The dog learns how to please its leader and that's very important to a dog.  Honestly, we could probably skip it because we've been to puppy school three times with our previous dogs. We know how to train and be a leader. But I still recommend it - it's a bonding experience with your dog.

And who knows? You might learn something new!

Trixie is the dog for me now. I need tender and sweet and loving at this stage in my life. The world is so harsh and I'm marching steadily towards the second half of life (my 47th birthday is days away - Oy vey!!). The phase of loss. The phase of reconciliation. Of coming to terms with potential not realized.

Many people my age cope by their children (getting married, achieving, identifying with their health and vigor, etc.) or their grandchildren (new life, wonder, tenderness, and hope), but that is not an option for me.

These are some of the secrets of older people - learning to live with loss and becoming so much more sensitive to the small but truly important things in life.

Back in the Pit

I am in the Pit.

This time, I have reason. We had to put Riley down last week. His seizures got much worse and it was time. We made the decision quickly after two nights of consecutive seizures in which he got hurt from the violent spasms. He banged up against his crate enough to bloody his nose and gums.

I don't have regrets. He was mostly gone, anyway - a mere shadow of his personality. He had a good life with people who loved him, who invested time and money into him,.

He came with us from North Carolina to Kansas when we moved. He was a companion/visiting dog for a little while. He liked to have a job and was so proud whenever he had his saddle bags strapped on, meaning he had work to do. He was a fierce protector. He loved a ride in the car and would grin merrily in the car the whole way, wherever we were going. He knew how to "sing" and he learned how to beg, how to lie down, how to "grovel," and how to "pray."  At times, he looked like a little teddy bear with his fluffy head and perked up ears.

It's just so sad. But nothing is forever and we have no choice but to accept.

The Downside of Pet Ownership

Riley, my 13 year old pup, is ill. He has a brain tumor and has been having seizures for about 6-7 weeks. After the first one, it became a once-a-day event, in the evening, whenever he went outside. We controlled it by not letting him outside after 7:30pm.

Now the seizures happen in the mornings when we let him outside, and we can't avoid letting him out then. After a night in the crate, he has to go out to pee. So, he has his seizure then he recovers. I make sure he doesn't hurt himself, or make too much of a mess, and I pet his writhing body, soothing him and telling him to breathe. He probably doesn't even know I'm there. The seizure ends, and he emerges, stunned and confused. It takes a while to recover completely, and as he recovers, he is little manic and he's voraciously hungry and thirsty. 

Some strange behaviors have started. He bit me one morning this week, and I'm certain he didn't know what he was doing at the time. He was in his manic phase, looking for something to eat and he was tasting everything nearby, just in case it was food. My big toe must have looked like a piece of food on the floor, so he went for it. 

Didn't break my skin, but it was a painful pinch.

Another new behavior is that he's howling. He only ever rarely howled throughout his life. Now, he points his nose up in the air, purses his lips, and lets out a soft, low "Ooooooooh."  He looks adorable in the coyote pose...but it's troubling. The tumor is probably stimulating his ancient wolf brain, and he feels the urge to call the pack.  Is he lonely? Is he hurting or frightened? Does he even know why he does it?  It's a mystery.

I hope he's not in pain. He doesn't seem to be - his spirits are good when he's not having a seizure.  

It's hard when it's the sweet dogs. Again, I just hope it's more clear than it is now when it's time to make the inevitable decision to euthanize.

Anxiety - Underlying and Insidious

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I can always tell when the anxiety is getting bad. My dreams get extremely strange or violent. Usually I am not committing the violence; instead, it is happening around me. My husband notices because I sleep very deeply and either snore or breathe very deeply, loudly, and heavily.

The source of the anxiety this week is my work. I am providing at-elbow support for physicians as part of a go-live of the electronic EMR in certain areas of the hospital. Technically, it isn't the hospital, it's the group of physicians who have admitting privileges at the hospital and their associated clinics.

Doctors are a strange breed of human being. Our society raises them in such a way that encourages antisocial behavior in the workplace.

Disclaimer

Before every doctor who has social skills and does, in fact, behave like a grown-up in their professional milieu takes offense - get over yourselves. You know this type of attitude and behavior is prevalent in your field. It's certainly prevalent in other high-value fields where people think they are deserving of special treatment (or normal treatment, as they see it). You know, like politicians, celebrities, etc.

Medical Office Culture

I don't think it's right to hire people whose job it is to make sure you don't get upset and you are happy. I don't understand why people tolerate this kind of work, especially thoughtful intelligent people. I don't understand why nurses minimize their independent practice of nursing to the emotional and logistical coddling of a physician.

No, I'm not moving to a medical office any time soon. I doubt they would hire me, anyway.

U.S. Medical System

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The defense of this behavior is the economic reality of our medical system in the US. The physician is the money maker. Physicians hire support people so they can maximize their hours billable at the maximum rate. Therefore, it is fiscal irresponsibility to have a doctor do such a "menial" task as fax a prescription refill to a patient's pharmacy. Or so they say.

It's a better to hire a secretary for this.

But our system places responsibility for the decision to prescribe on the physician, and it is illegal for their support staff to prescribe. We've worked out an elaborate proxy system that the physician minimizes the amount of time considering the prescription. In other words, the person who really makes the decision whether a prescription can be refilled is the medical assistant, the physician's assistant, the professional nurse, or the practical nurse, and in some cases, the secretary (not medically trained). They do all the logistics so the pharmacy can dispense. The physician gives her stamp of approval at a later time, maybe in some cases, after the med has already been dispensed.

Don't get me wrong. These people are thoughtful and through their experience working in the field, they develop an understanding of the conditions, the course of illnesses, and standard treatment protocols, and they know the patients. Workers who learn in this manner are effectively apprentices. However, we don't do apprenticeships in the USA, we do university degrees and certifications.

That's the dichotomy that causes me so much disdain for physicians. They expect their staff to be smart and trustworthy and loyal, but the second they overstep their bounds, they thump the staff person on the head with "you're not the professional here." Bullshit. The trust must go both ways, or the physician should do this stuff themselves, and actually take care of the patient holistically.

American Royalty

google.com

Back to the antisocial part. Maybe what bugs me about this is that when I argue that my time is valuable and high dollar value, that is scoffed at because we all must pitch in.

Doctors don't have to pitch in.

The physicians received some pretty damn expensive at elbow support from me. I am an expert at analysis, design specifications, and strategic development of information systems. And I am sitting around waiting for them to verbally abuse the organizational changes that force them to change their work habits. Who is the thing you can yell at? Me, the messenger....I receive the vitriol.

What really makes me angry and gives me stress is that I must accept this castigation about a system that I had no involvement in designing or building. I defend decisions I did not make and in many cases do not fully understand. Furthermore, I have limited power in changing the system to coddle the physician.

When the physicians understand the whys and wherefores behind the organizational changes it's not bad at all. When they are the spoiled children who whine when they don't get their way, it's hellish because I cannot treat them as the over indulged, princes they act like.

In my observation, it's mostly the men that act this way. The women tend to be a little more team-oriented.  Yes, yes, there are exceptions on both sides of the argument. I'm merely commenting on my experience.

And what really twists the knife for me is that what I know about the software we're using, it's so freakin' physician-focused that I don't know why they complain about anything! The rest of the staff is (metaphorically) using the system in Hebrew, on a monochromatic CRT screen, with one arm tied behind their backs and a boxing glove on their remaining one hand, to make the physician workflow work "effortlessly," and the physicians have the balls to bitch about how awful the system is?

My God! The system doesn't read my mind. It only does what I told it to do. It must be crap!

Spoiled. Little appreciation or understanding of the bigger picture and the role of the team that got them to that point.

But when they receive the check from the government for Meaningful Use achievements, they will pat themselves on the back to say what a great job they've done.  When they publish the research based on data that they merely extracted from the database in a single query in 2 hours, they will receive accolades on how clever they are.

I have a lot more to say to work out this anxiety.