Tuesday, January 26, 2010

A Little Economic Humor

From one of my church group:

I got a pre-declined credit card offer in the mail.

I ordered a burger at McDonald's and the kid behind the counter asked,"Can you afford fries with that?"

CEO's are now playing miniature golf.

If the bank returns your check marked "Insufficient Funds," you call them and ask if they meant you or them.

Hot Wheels and Matchbox stocks are trading higher than GM.

McDonald's is selling the 1/4 ouncer.

Parents in Beverly Hills fired their nannies and learned their children's names.

A truckload of Americans was caught sneaking into Mexico.

Dick Cheney took his stockbroker hunting.

Motel Six won't leave the light on anymore.

The Mafia is laying off judges.

Exxon-Mobil laid off 25 Congressmen.

Congress says they are looking into this Bernard Madoff scandal. Oh Great!! The guy who made $50 Billion disappear is being investigated by the people who made $1.5 Trillion disappear!

And, finally...

I was so depressed last night thinking about the economy, wars, jobs, my savings, Social Security, retirement funds, etc., I called the Suicide Lifeline. I got a call center in Pakistan and when I told them I was suicidal, they got all excited, and asked if I could drive a truck.

Sunday, January 24, 2010

Mom's Funeral Wednesday 27 JAN 2010

Visitation at JOHN L. ZIEGENHEIN & SONS, 7027 Gravois Wed. 11 a.m. to 2 p.m. Then to St. Matthews Cemetery for 2:15 p.m. Funeral Service.


Friday, January 22, 2010

Margaret V, Greer, RIP, 2010 CST 22 JAN 2010

Mom died at approximately 8 PM tonight. I was the one to discover her, taking over the night watch at her bedside. Linda and Chuck had seen her alive when they left for dinner around 7 PM.

The Charge Nurse confirmed no pulse, and no respiration at 2010, five minutes after I had arrived at 2005. The resident confirmed it minutes later.

She died peacefully, and relaxed. No signs of pain or distress were present.

The nun (Sister Maureen) and I said a prayer for her.

Linda is the executrix/Personal Representative of her will. Funeral arrangements are being made for the prepaid funeral at Ziegenhein Funeral Home on Gravois:


Further details will be posted as they become available. The ceremony will have a closed casket, at Mom's request. Mom also requested no flowers be sent, and that donations be made instead to the Schleroderma Foundation:



Mom's Condition 22 JAN 2010

I'm sorry, but this is not good news.

I saw Mom at 1730 at the nursing home. She seemed physically better, but was restarting the generational war with the staff. Linda visited as well, and we agreed that things were looking up. She was able to stand, and walk a bit, and was using the facilities. The only bad sign was her downer outlook, and her refusal to eat very much (to avoid the bathroom). I left, and Linda did a little later.

At 2030, I got a call from the nursing home: Mom was collapsing; her BP was way down, and her O2 saturation levels were dangerously low. Back to the ER for Mom. I got there first. Linda arrived an hour later.

He BP was 90/35, and her O2 sats were in the low 80's. A "pressor" drug was used to raise her blood pressure, (it once got up to 110/60 or so) and she was given pain medication for her legs. Antibiotics were still being used for her right leg's infection. The white blood cell count was down to a near normal level.

But Mom had issued a stricture before the pressor drug was applied: If it didn't work to increase her oxygen levels, all treatments were to be suspended except for pain remediation.

Bad news. Even with the elevation of her blood pressure, her oxygen saturation levels hovered, at best, in the low 80's. X-rays showed advanced congestive failure patterns, and fluid was building up in her lungs. Around 0200, her BP started dropping as the pressor drug wore off. Her hands were cold, and cyanotic. She was coughing up constantly, and her urine was dark. Dr. Brown, the ER doctor, stated there was little chance of a full recovery, and she would need to go to ICU for intensive therapy. If she was not maintained on the drug, her low blood pressure, and low oxygen levels would mean permanent tissue damage. Even if she recovered, she would be on O2, and need continual assistance permanently. A blood thinner would also be likely prescribed, to forestall a pulmonary embolism.

Mom refused further treatment. At 0245, in the presence of the doctor, and witnesses, conscious, and competent, she requested that all treatment, except for pain, be withdrawn. This matched the medical directive that she had drawn up for herself in 2002. Linda stated that we should honor her wishes, and I reluctantly agreed. Both of us hold jointly the medical Power Of Attorney.

Linda, and Chuck, her boyfriend, stayed. I said goodbye to Mom, and left. I didn't want to watch the end of the show. Her BP was roughly 60/35, and dropping, when I left.

She will be taken to an ordinary nursing floor. How long she will live is unknown, but with the condition of her pulmonary system, it is unlikely to be long.

Wednesday, January 20, 2010

Observations 20 JAN 2010

I have not posted for some time. There's a good reason for this. Mom is now in Room 305 of the Bethesda-Dilworth Skilled Rehab Facility.

How she got there is the story of the last month-plus.

When I moved in to take care of her, she was still mobile. She appeared to need only minimal assistance (driving, shopping, some fetching and carrying). Her spirits had improved. The dog was now her well-loved buddy, not a rival. She now had a live person to talk to.

But after the holidays, and after the severe cold set in, she began to physically deteriorate, rapidly. I discovered problem after problem that had been concealed. Numbness in the limbs. Extremely poor sleep patterns. Depression. She was showing signs of pulmonary distress when getting up and down.

More and more, I was being turned into a full-time LPN. Bathing. Clothing. Y'all know the details.

Last week, she had three falls. She refused to see a doctor, or seek care for the first two. On last Thursday night, it took an hour to get her out of her living room chair. A half-hour for the bathroom. Then, I put her in bed with instructions to call me for anything, and not to get out of bed.

0550 Friday morning, a gigantic crash was heard through the re-enforced concrete ceiling. I ran upstairs, and found her between her bed, and the side table, with her head (left side) on the open door of the side table. Both of us knew the game was over. Her gamble to die at home had failed.

911 was called, and the STL City FD responded rapidly and professionally. She was immediately taken to St. Mary's Hospital ER. Her BP at one point was 90/49. Her blood sugar count was 55 (!!). She had been deliberately reducing her food and fluid intake to reduce the need to relieve herself- and starving herself in the process. Her O2 saturation's were dangerously low. Every sign was there that her congestive heart failure was worse. Her right leg was infected, and inflamed. No cranial bleeds were shown in the scans, but there was a lesion on the front temporal lobe. She was disoriented, and in pain.

By noon Friday, she was stabilized, and taken to Room 367, on the med-surgical/oncology wing. That's when the generational war of nursing began. Mom could not understand the rigid, by-the-numbers style of modern medicine. EVERYTHING was scanned, and entered into the computer. Every vital sign, every action taken recorded. The staff had no choice. The nursing staff were facing a three-day weekend, reduced staffing, and a rush of critical patients.

Mom, of course, wanted to direct her own care, and had managed to make herself PNG by openly degrading the staff. "We never treated patients this way! This hospital is a Gulag!"

The Silent Generation Uber-RN was having a collision with a Boomer/X'r managed healthcare system, staffed mostly by Millies.

Enter Wally the Peacemaker (Generation Jones, 1959). For five days, I acted as liaison for Mom. The Charge Nurse was openly relieved whenever I showed up- I stopped the call button from being pressed every 13 seconds, and managed to pull off some diplomatic miracles. I fended off at least one coronary (on both sides).

My sister was doing her part by scouting long-term care facilities. I pity the administrators subjected to her not-so-tender mercies.

Both my sister and I have Power-Of-Attorney. We split the duties- she would handle the medical hassles, I the financial and legal ones. Again, do not have an emergency on a federal holiday weekend. Tuesday and Wednesday were burned off, because Monday was MLK day. The same applied to the high and mighty specialist departments. Tuesday is usually spent getting the backlog cleared. Wednesday, the work got done.

Tonight, Mom is much happier in the better staffed rehab facility. "They didn't say goodbye to me!" she complained about leaving the hospital. I will leave it as an exercise for the student why that would be so.... :)

Did I mention the paperwork?

I no longer needed an alarm clock. My sister would wake me up by cell phone with the first demands of the day. Then Mom would call, demanding that the entire contents of her house be brought to her.

My dog misses Mom. He can tell something is wrong. He loved the firefighters and the paramedics, and they liked him. But afterwards, Mom's absence was felt.

I am now convinced, more than ever, that we are going to have a breakdown of the medical system. The political system is equally compromised (as shown by the legislative antics of both sides). At some point, the Millies and the Artists now being born will simply not put up with the mess we have created. Be nice to them- you would not believe the difference treating them decently can make. I found that out first hand. They couldn't believe I was a late Baby Boomer, because I was both nice, respectful and understanding of them, and politely assertive. And funny.

I doubt my debate board opponents would have pulled this off, from their online demeanor's. The staff was shocked at how much I knew about medicine. They were greatly amused when I explained my military background, and why we got buried for our mistakes, while doctors buried theirs. Take *that*, Your Majesty. The staff also liked the old joke that we didn't think we were doctors, but the doctors thought they could be pilots... :)

Mom is much happier (and healthier) now, in the rehab center. She has now a goal to work for. Much depends on how badly her heart and lungs were damaged. She's still on O2. The weakness and numbness in the right limbs is also a major concern. If she returns home, she will need to be supervised, since she will go off-leash, given the chance. The car is being sold, since we now know she will not be driving again.

Many thanks to my employers, for understanding, and allowing me the time off to deal with this situation. Thank God I get to go back to work. That will be a vacation.