Park Logic 101… Again…

Spent the day in The Park with Mom for medical follow up.  We met “Robo Doc” to see if she is a candidate for “robotic assisted laparoscopic bypass”, which would be much less invasive than traditional bypass surgery. 

Alas, no robots – she passed the pulmonary function test, but since one lung must be deflated for “robo-bypass”, Robo-Doc (who is just as cute as a tall, scrawny, geek button) said that with her pulmonary hypertension, it would put too much stress on her heart.  It shall be traditional double bypass.

My regular readers might remember my last run in with Park Logic.  Today?  Another Park Logic Moment:

Robo-Doc said the biggest risk during bypass is pneumonia, driving the 4-5% possibility of fatality from the procedure.  Her chance of getting pneumonia more than doubles if she keeps smoking* before/after the surgery – so Robo Doc virtually demanded that she quit smoking for 2 weeks prior to surgery.  That meant no smokes starting today since she’ll need to be cut soon.

He prescribed Chantix. She immediately raised concerns about side effects, based only on info she’s seen on television.  “That stuff messes with your brain, doesn’t it?”.  He explained that it satisfies the craving without the nicotine, that he’s had many patients successfully quit using the drug, and that he felt the side effects were less threatening than those from smoking prior to surgery. 

In the car, as we headed to fill the prescription, she started whining about not wanting to deal with Chantix – the strange dreams (one potential side effect) would drive her batty**.  i helpfully pointed out that the side effect of smoking was that it jacked her chance of complications (including death) from bypass to over 10%.

Thinking “Woo-Hoo!  Take that!  Logic rocks!”

At the pharmacy, we learned that this particular drug is not covered by her new insurance plan.  Mom suggested we head home and call Robo-Doc back to see if he had a Plan B.  Thinking quickly despite the lack of sleep and caffeine, i asked the pharmacy tech “how much?”.  $117.62.  My charge card was out in a flash, drugs in my hand and we were on our way before Mom could finish her protest statements. 

She offered to pay me back, but of course i declined.  And again being the helpful daughter that i am, grinned at her and said “Besides, now you’ll feel guilty if you don’t use this stuff.  Paybacks are hell, ain’t they Momma?” 

Thinking “SLAM! DUNK! I am a logic MACHINE!” 

Still complaining about the cost of the demon medication, i once again went to my Big Bag O’Logic and reminded her that she spent $160 on four cartons of cigarettes the last time i took her to the cardiologist. 

Thinking “DOUBLE SLAM, BAY-BEE!!!  I RUN RINGS AROUND YOUR LOGIC!”

We headed out for a late breakfast before i took her home.  i was feeling pretty good, having scored some serious logic points.  Ordering a healthy breakfast (Egg Beater omelette, fruit instead of fried potatos, english muffin instead of gravy/biscuits), Mom went for her usual:  Two eggs, basted in butter, 3 slices of bacon, 2 biscuits with a bowl of sausage gravy.  Yes.  i said “Bowl”.  i said “Gravy”.  When asked about the breakfast potatos, she said “I’ll skip those – the doctor said I need to start watching the fat in my diet”.

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* Mom has been smoking for roughly 65 years.  Current rate is about 3 packs/day.  On her “pulmonary function test” results, amongst the demographic stats such as age, weight, etc. was a note: “98 Pack Years”.  Something akin to “Dog Years” i suspect.  i’m surprised it was that low… she must have lied…

** i get “Nyquil Psychosis” after dosing myself for 3 days.  i start to have amazing dreams – sometimes “Hostel”-like mad slasher flicks, sometimes hallucinogenic road trips!  Almost makes me look forward to going to bed when i’ve got a head cold!

The Clampett’s Take Granny To The Hospital

You’ve seen the episode.  Granny needs a routine medical procedure, but the Clampett’s don’t trust them smarty-pants doctors and them new-fangled doctorin’ machines.  With a show of force that could have changed the outcome at Normandy, the Clampett clan descends upon a poor, unsuspecting hospital staff, unleashing their homespun brand of hillbilly hijinks, and much hilarity ensues.

 

 “Hilarity” is one word for it.  My word for it is “shoot – me – the – fuck – now – i – cannot – POSSIBLY – be – related – to – these – sociopathic – mutant – hillbilly – fucktards”.  For the purists out there, yes – i can count.  i tried the thesaurus.  There was no single word that captured the complete sentiment.

“Bitter The Apple”

Mom picked that title – “Bitter The Apple”.  From my earliest recollection, she always said that if she wrote the book of her life, that’s what she’d call it.

Even as a young child, i found it depressing.  I couldn’t figure out why her life was so awful?  We lived in a working-class suburb – owned our own house.  There was a gigantic farm field behind it, suitable for endless games of “capture the flag”.  And woods – where we used stolen construction supplies to build amazing tree forts.  The neighborhood was full of kids – we were never lonely and there were adventures to be had!

The family was quirky, mealtimes were loud, six of us were crammed into a smallish house, but we were all healthy and shared lots of laughs.  Dad had a good job – we didn’t see him much during the week, but he was always around on the weekends, working on projects, leading discussions on philosophy, music and life, or teaching us to throw a variety of balls at each other.  We went camping every summer – where bathing was entirely optional for a week!

Why was Mom so bitter?

If the Raisin Ranch is Rockin’…

This post is dedicated to the lovely nursemyra – an inspiration to all in her devotion to historical (and hysterical) medical research… 

On my recent visit to The Park i learned a most fascinating medical fact from the brilliant and pharmaceutically savvy Dr. M.

The last echocardiogram done on Mom showed potential signs of secondary pulmonary hypertension.  In short, her lifestyle choices* have not only destroyed the cardiac plumbing systems, but are starting to affect her ventilation system as well…

While we were discussing diagnostic options – to include heart catheterization in a couple weeks – i asked exactly what Dr. M was hoping to discover through the testing.  She explained – using the cutest little heart puzzle thingie i’ve ever seen – that she wants to know whether Mom’s misery is coming from the heart trouble or the lung dysfunction.  By determining the source, she can make a better decison about treatment options.

Knowing this was a possibility i’d done some surfing on the topic before the visit.  It was my understanding that there’s not much that can be done to treat secondary pulmonary hypertension.  Thanks to Dr. M’s diligence in staying on top of the latest research, i was delighted to have her correct me.

There are pharmaceutical approaches for treating pulmonary hypertension – depending mostly on the reason for increased pressure in the lung plumbing.  Among other drugs, Viagra has been shown** to effectively treat some forms of pulmonary hypertension.

Mom: You mean you might put me on Viagra?

Dr. M: I’ve got several ladies using it…

daisyfae: Good grief, she’s already a demon!  The men at church are terrorized! At least give me time to get a warning out on the church ‘prayer chain’!

Dr. M: Don’t worry – women don’t have the same reaction as men, so there wouldn’t be much effect on sex drive.

Mom: damn…

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* maybe i’m being a bit judgmental here, but it seems that smoking 3 packs of cigarettes a day for 65 years will do a little something to your health…  add in the salt/lard/bacon-based diet and take away any form of exercise and you’ve got the equation for stroke, emphysema or heart-attack… or just a multiple-organ mutiny saying “we’re mad as hell and we’re not going to take it any longer…”

** Dr. M went on to explain that Viagra was first developed to treat pulmonary hypertension.  When the clinical trials were over, the men involved begged to keep taking it…

Bitches and roses…

i don’t want to get in the habit of just “ranting”, although it’s fun and relieves stress.  Since i spent most of the day in The Park, taking Mom to the cardiologist, it would be easy to drop into “rant only” mode – so the ground rules for tonight are “at least one positive thing for every negative thing”, but i can earn extra “rants” as needed by spending an additional 10 minutes on the elliptical trainer tonight.

Here goes… i’ll start with a bitch.*

Bitch:  Alarmist local media – waking up at 0500 to get Mom to the doc by 0900, the first bit of weather news was dire: Frozen Highways of DEATH!  Major Rush Hour Disaster Looming! Only the crazy should venture out!  Knowing that the trip to The Park today was mandatory (due to potentially serious medical issues for Mom), i had to steel myself for an awful drive.  The reality of it was – roads were fucking fine…  bastards… but hey, i got there in time for a cup of Mom’s Homebrewed Decaffeinated Sludge…

Rose:  Dr. M, the cardiologist of my dreams (see footnote about Dr. M here) was absolutely brilliant as she handled stressful news.  Mom will need additional diagnostics, to include extensive heart catheterization.  Dr. M was patient, attentive and communicated the issues effectively to Mom – minimizing worries about the impending procedure.  All medical personnel should be so considerate and genuine…

Bitch: Returning to Mom’s house after the doc appt, i needed to shovel the 4″ of snow in the driveway.  I had to walk next door to get the snow shovel from DQ’s house.  It was past noon, and both DQ and BJs cars were in the driveway – both home sleeping in on a weekday.  Neither had bothered to get up to take care of the chore at hand, or get Mom’s trash to the curb.  Or change 3 burnt out lightbulbs in the house….

Rose:  When discussing possible venues for the angiogram, we had the option to choose a hospital – either the ‘downtown’ hospital, known for exquisite cardiac care, or the suburban hospital, more convenient to The Park.  i asked Dr. M about prospects for more serious issues arising, such as the need for bypass, and if she would be comfortable working at the suburban venue.  She said “The Chief Surgeon there is Dr. B, and he’s very good. No concerns.”  I said “Wait a minute… i think Dr. B was Dad’s thoracic surgeon… is he tall, salt-and-peppr hair, and, um, and really hot?”.   And the lovely Dr. M replied “He’s ok… i mean, if i were eating a sandwich i’m not sure i’d look up if he walked by…”.  (i’m wondering if this isn’t worth two roses…)

Bitch:  Getting old…  We’re all circling the drain, man.  Whether it’s Mom quietly acknowledging that she’s not just in the fourth quarter, but at the two minute warning… Or me realizing that my life and plans must take a back seat to caring for Mom for the forseeable future – for both of us, it’s gonna suck.

I’ve said it a million times – we can’t really change the outcome, but we can influence the path.  Finding ways to help her feel better, so she can enjoy herself a bit, and have things to look forward to… That’s the best i can hope for…

Rose:  Looks like i’ll be spending more time with Dr. M** this year…

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* quote from one of my favorite rap songs, Dr Dre’s “bitches ain’t shit”… covered nicely by Ben Folds here.  Strong language warning…possibly every other word, in fact.

** I always admire women who are intelligent, competent and accomplished.  But whenever i run into such a creature and she is also gorgeous?  Instant crush…  what the hell is up with THAT?!?!?

Ghost branch in the family tree?

When we last left Mom and her gummed up hydraulic and ventilation systems, her juicy-hot cardiologist* had determined the need to switch up the medications for her high blood pressure.

There is always a bumpy transition when reducing the dosage of the old drug, and ramping up the new one.  The edible Dr M reviewed the process carefully, and painstakingly went over the symptoms which would trigger a call to the office – spike in blood pressure, drop or spike in pulse rate or heart palpitations.

When we got back to the house, I asked DQ to come over from next door to go over the dosing schedule for the next three weeks, as well as warning signs.  Heads nodding in understanding all around – like a Smoking Bobblehead Convention – i was confident that marching orders were delivered and received.

Three nights ago, I got a call at 11 pm from DQ.  Mom had been having heart palpitations for a couple days, and just told DQ about it an hour earlier.  DQ, remembering that this is one of the bad things, wants to call me (she’s a reliable and diligent soldier when given orders). Mom argued with her about bothering me so late – but DQ did call.

After beating through it, and spanking around on the web, we decided it could wait til morning – but that it would be prudent to call the cardiology shop first thing in the morning.

The next day I called mom while driving home, to see what the doc said….

Mom:  “I didn’t call”

daisyfae: “What?”

Mom: “I felt a little better this morning.  I don’t want to be a bother….”

daisyfae: “Ma, this is why we pay them. Haven’t you noticed all the Mercedes and BMW’s in the physicians parking lot?  They don’t mind….”

Mom: “I was afraid you’d have to take off work and come down here if they put me in the hospital for tests…”

daisyfae: “Thoughtful of you, Momma, but I’d rather deal with that than deal with you stroking out on us….”

In my head, I quickly climbed the limbs of her Appalachian-American** family tree.  Czech, German, English….  Nope.  Not Jewish. 

So where does that “I’ll just sit here quietly in the dark until my heart explodes” thing come from?

——-
* Dr M is about 35 years old, gorgeous, considerate, wicked smart and has the patience of a saint. She wears those sexy Tina Fey “smart girl” glasses.  Yeah.  I’ve got a girl crush on her.  Get over it.  Of course, that’s not the only reason I take an entire day off work every few months, get up at 5:30 am, do full “hair and makeup”, drive 120 miles round trip and spend an hour in the waiting room listening to Mom recount the details of every meal she’s eaten for the past week.  I am there to ensure Mom gets to spend a few minutes with the cardiologically brilliant Dr M.  Really….

** Redneck

A day in The Park

I took the day off work, and went to The Park to take Mom to visit her cardiologist.  A few vignettes from the day…

     – when i arrived to pick her up, she was having breakfast on the couch.  coffee and potato chips.   she then tells me the story of DQ, Jr (12 years old) and a friend getting arrested at a movie theater for taking video for the last few minutes of the Hanna Montana movie.  No charges filed, but damn good drama all around…

     – the doctor asks many questions, including “how are you doing with your sodium?”  Mom answers the question, saying she has switched to sea salt, and thinks she’s doing ok.  i wait… until i can’t stand it any longer and casually mention her daily breakfast of potato chips and the fact that she unloads at least a half shaker of salt on everything (including her coffee) prior to tasting it.  65 years of smoking will do that to your tastebuds, i suppose.

     – Mom’s blood pressure is high (170/60) and her pulse is low (55).  Time to change her meds!  she tells the doc that it’s been like this for a few months – and that there was one night in December her pulse was 48.  doc is concerned.  i am concerned – and frustrated, because this is the first i’ve heard of this.  remember that little surprise we dropped on her a few weeks ago?  it really could have caused a stroke…

     – driving from the doctors office, she finished her cigarette in my car.  picking her up in front of the cardiology building while she’s blowing smoke rings out her nose? doesn’t really phase me much anymore.  i don’t care for smoking in the car, but it’s not like smoke will make the shitmobile smell worse.   on the highway, she mentions that she isn’t sure the cigarette went out the window.  it didn’t.  i managed a quick recovery of a smouldering butt from the back seat, while driving 70 mph leaving only a small flesh wound in the upholstery.  good thing i don’t care…

     – at the house, DQ (niece next door) comes over to review the medical info.  DQ, Jr. is asked to take the 5 month old baby, DQ, III, into the other room so Mom and DQ can smoke.  I’m encouraged that they are at least not trying to smoke near the infant.  As DQ lights up and blows a big ol’ cloud of smoke toward me, she informs me she’s pregnant again.  That it was an accident – “…we were being careful…”.  What?  By only screwing on days that end in “Y”?

As far as these things usually go, it really wasn’t bad.  Just another day in The Park…

Some things never change…

I call Mom at least once a week, always on Sunday evenings.  Tonight?  I called from the car, driving home from a full day of ‘tech’ for Hair.  After the initial ‘how was your week?’ discussion, where i generally get a run down of everything she’s eaten since last Sunday, there was this:

daisyfae:  We had a good first tech run through of Hair today – still a bit rough, but it’s coming together.

Mom:  You’re doing another show?

daisyfae:  Yes, remember?  I’m sure i’ve mentioned it – i’m working backstage.  Couldn’t pass up the chance, since i’ve loved the music for this show since i was a kid…

Mom:  Oh, that’s right… but you’re not in it, are you?

daisyfae:  Well, as a matter of fact… i’m doing a short cameo appearance.  The director and cast have invited me on stage for the naked ‘be in’ scene.

Mom:  [pause] Naked?  You’re getting naked?  On stage?

daisyfae:  At least partially naked – tonight i went topless.

Mom:  But you’re wearing a bra or something…

daisyfae:  Nope.  Last time i checked, the definition of ‘naked’ was ‘naked’.

Mom:  Showing your boobs on stage?  At your age?

daisyfae: [smiling] Yes, Ma’am!

Mom:  ………

Priorities

I’ve yet to write much about my Dad – not sure i’m ready.  He died in 2002.  Rather than tackle that, here’s an indirect look, providing another glimpse of life in The Park.

Dad was diagnosed with late stage colon cancer in 1998.  The prognosis was grim, with somewhere between 6-12 months expected.  Mom, a retired psych nurse, proved to be a rather remarkable caregiver, devoting incredible energy to keeping him alive.  He lived until 2002, and of the last years, there were some good moments and her efforts gave us more time.

Genetically, we are not a family of ‘wasting away’ people – even after over 3 years of chemo, he was still around 260 lbs when he died.  After a fall in his room, it became obvious that we might need to rearrange the clutter in the house to allow better access for the emergency squad if necessary.

I suggested to Mom that we temporarily move a bookcase full of old record albums to the garage to clear a path down the hallway.   This was reinforced by my brother-in-law, a paramedic. 

Her response:  “We’ll just go out the window with him…”

Before i could censor myself: “Did you just say that a bookcase full of dusty old records is more important to you than my dying father’s dignity?”

Defensively – “that’s not what i said…”

“Well that’s what i heard”.

My brother-in-law and i quietly moved the bookcase to the garage that weekend.  And after Dad died, i moved it back without fanfare. 

Every time i visit, i see it sitting there, amidst the overwhelming clutter.  Unused.  Covered with dust. Still pissing me off…

Things before people. 

Not a conscious thing…hardwired into her.  Growing up during the depression did that to some people.  But it’s always there – and i’m still trying to let it go.

“I’m bitter and i can’t get up…”

Mom is 79 and still lives alone, although my 35 year old niece, DQ – the true Queen of the Park – lives next door.  For Christmas this year, rather than buy Mom more clutter for her house, i bought her a Life Alert system.

I arranged for installation Tuesday, and made sure that the installation was coordinated with DQ.  Although she’s sometimes a human disaster area, she can be very functional – especially when her future inheritance may be at stake.

After a long and painful day at work, i called Mom to see how things went.  She barked at me for 20 minutes…

“Well, they didn’t show up on time…”, and “the paperwork was all messed up…” and “it had to be put 4′ away from the phone…”.

You get the idea.

I’d been up since 4am, was emotionally exhausted from work, and was driving home in heavy traffic during a rainstorm (yes, i know i shouldn’t use the cell phone when driving…).  I didn’t know what to say, other than “Mom, i’m really sorry i got this for you.  I can come down tomorrow and take it out…”

She went on for another 10 minutes about what pain i’d caused her…

I explained “you made it clear to us that you want to stay at home, rather than go into assisted living.  we need to provide a strong safety net for you.  this may not be the right solution, so we can keep looking at other options”.

Another bark-fest.

I gave up.  “Mom, I’m really sorry i got this for you for Christmas.”

And then the icing on the cake from her…

“You make me sound so ungrateful”.

oh.  i’m sorry.  what an awful person i am for implying that a half-hour bitchfest without a ‘thank you’ regarding a gift that is intended to keep you safe is an ungrateful response. 

[sigh]

no.  i didn’t say that.  asked her to sleep on it and checked back with her on Wednesday and she’d adjusted to the idea.  i know that it’s the loss of her independence she is mourning, and i need to be very patient.  or very medicated…