Thursday, February 25, 2010

Keith Olbermann on "Life Panels" and Health Care

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I didn't catch this last night but saw it posted on Momocrats.

Olbermann speaks of a very personal situation - his own father's illness and the choices that he has had to make - and relates it to the current debate on health care, pointing out the claim by members of the GOP that there would be "death panels" to be absurd, and also showing how lack of insurance can taint decisions that should only be between the patient, his or her health care proxy and the doctors.

It is very moving; you'll need about 10 minutes of free time to watch it if you haven't already seen it, but it's worth the time spent. Naturally this seemed very pertinent to me given my recent (and ongoing) situation with my mother.

I didn't get to see much of today's health care summit, but did catch the last part when President Obama wrapped it up. From what he said it sounded as if the GOP did not yielded on any major points, which certainly didn't surprise me. They also all looked very sulky as the President talked.

I hope he and the Democrats in Congress will go forward without them and use reconciliation to pass as much of the health care bill that they can. Something has to change because our health care system is broken.

Wednesday, February 24, 2010

Haiku Wednesday

Winter seems endless
I'm so tired of winter coats
And sloppy weather.

More snow is coming
The weather forecast is dire
I'm so sick of this!

Naked black branches
Against leaden winter skies
So very dreary...

Winter is boring
The dog has cabin fever
The cat doesn't care.

But there are some signs
That spring will be returning;
I hear birds singing.

And on the TV
I hear pitchers and catchers
Have come back to train.

I know it will pass,
This long winter from Hades
But please, tell me when!

Saturday, February 20, 2010

Reports of Her Death Were Greatly Exaggerated

Well, it has been quite the week (or week and a half I guess it really is) since I last posted here. As I'd mentioned previously, my mother had been ill but the hospital did release her to a very nice nursing home down the street from our house for further rehabilitation. So I'd been visiting her every day and she was coming along, although not back to her old self. But after she was there about four days, they called and told me she was being sent back to the hospital due to low oxygen levels and irregular heartbeat.

After another long evening in the emergency room, she was admitted to the hospital and I went home and went to bed. When I got there the next day I ran into the pulmonologist who was treating her (whom I'd never met before) outside her room in the hall, and he told me she was very critically ill and pretty much said that she might not make it out of the hospital. He then asked if she has a living will, and whether I had signed a "Do Not Resuscitate" order for her. I said no, I hadn't, and since just yesterday she was sitting up eating turkey dinner and talking to me, I wasn't going to sign one now either. I got the impression he disapproved of my decision.

Now, my mother is 91 and a lifelong smoker, and yes, she was in pretty bad shape. Apparently she now has fairly severe Chronic Obstructive Pulmonary Disease (emphysema as we used to call it back in the day) and it had started to catch up to her. But given all her female relatives lived well into their nineties, I wasn't writing her off just yet. I felt she still had "a lot of good left in her," so to speak!

Nevertheless, I was highly worried about her after my conversation with the pulmonologist - and more so when I returned to the hospital later on to find they had had to entubate her and she was on a ventilator in the ICU.

I thought this was it and was thinking maybe I should sign the DNR order...I went to talk to the attending physician in the ICU, and thank goodness he wasn't as much of a Mr. Doom and Gloom as the pulmonologist. I asked him if anyone ever comes off these ventilators once they're on them and he said "Of course! In fact, your mother is responding quite well." So I told him to keep actively treating her but if her heart stopped not to revive her.

So there I sat, at what I thought was my mother's possible deathbed. She was on the ventilator and couldn't talk, she was partially sedated, but she knew I was there and could nod and squeeze my hand. I started to tell her what we all want to tell our mothers on their deathbeds, how much I appreciated all she had taught me, that I loved her very much, that I was sorry for all the times I'd been impatient with her when she needed me to do something for her, and so on. Tears streaming down the cheeks, the whole bit.

Finally I left and went home, took a Xanax and went straight to bed.

The next morning I got up and called the hospital with trepidation to see how she was doing, and was astonished to have the nurse tell me "Oh she's coming along very well, we're weaning her off the ventilator and she's doing much better."

I got to the hospital and sure enough, my mom was awake and although she still had the tubes in her mouth and throat to help her breathe, they weren't breathing for her anymore, and she could nod and gesture to try to make me understand what she was trying to say. She also could write! So, although her eyesight isn't good so her writing is hard to read, at least I managed to understand what she was writing on a pad of paper.

By the next day the tubes were out and she could speak, and was much better than she even was before she went back into the hospital. Apparently her biggest problem is the COPD and the levels of carbon dioxide in her blood were too high - which causes the blood to become too acidic and can affect the brain, make a person sleepy and groggy all the time (all the symptoms she had had previously) and it basically isn't very good for a person altogether. In fact, if it goes too high it kills you.

The reason she had gotten so much better is the ventilator had helped her get her blood gases back in balance the way they should be. If I had signed the DNR order, she never would have been put on the ventilator at all, as that would have been considered extraordinary/heroic measures.

Today she is down to no oxygen mask (just the little tubes that go into the nostrils) and she is eating solid food again and is no longer in the ICU. My aunt and husband and I all went to see her and had a nice chat while she ate her dinner.

First of all, let me say that I know the pulmonologist meant well, and because he had no idea what my mother was like or what her background and situation were, he was just being honest about what he saw her condition to be, and what its prognosis might be.

And I also want to say that anyone who is in the position of signing a DNR order for a parent (or anyone else) and does so, has my greatest respect and sympathy. I did it for my father when he was in a nursing home with Alzheimer's Disease at 92, and had no hope of recovery. I never had any regret about it and was relieved when he passed shortly thereafter, as I knew he was out of his misery.

But it isn't always as simple as it seems. You have to really know what your parent or loved one would want, and how they approach life. My mother always has a positive attitude toward whatever situation in which she finds herself, and keeps her sense of humor no matter what happens to her. Naturally when I thought she was on her deathbed I started thinking those thoughts that are supposed to make us feel better..."Oh, she wouldn't have wanted to live like this anyway, always on oxygen and not being able to smoke her cigarettes, and all..."

But in reality that isn't how she would have felt at all. When she was much improved the next day but still not able to talk, she was gesturing to the tubes and trying to communicate to me. I said, "You want me to take out the tubes?" She shook her head no. "Do you want to get better and go home?" She nodded yes. Turned out she was just trying to tell me she couldn't talk because of the tubes and was aggravated about it. The next day I told her my first thought was she was telling me to "pull the plug" and she laughed. That was NOT her intention whatsoever.

I'm just telling this story to remind everyone to have these conversations, no matter how difficult, on a regular basis with your elderly family members. My mother had signed a living will 15 years ago but I had no idea whether she still didn't want "extraordinary measures," nor under what circumstances she wouldn't want them. It's easy to sign something like that when you're relatively healthy and younger and think you wouldn't want to live with various bad conditions when you're older. But when you get to "older" you may think differently!

As far as I can tell, a living will is really more for the family member who is in charge of the person's medical decisions when they are unable to speak for themselves to be able to make the difficult decisions. If an ill person really doesn't want extraordinary measures to be taken, and you as the caregiver really know it, you can produce the living will to legitimize it and enable the hospital and health workers to proceed accordingly. That is because they default to the "do everything you can" option unless told otherwise.

But even if a person has a living will, be sure to check with them occasionally to make sure you understand their real wishes and what wishes they would have under which circumstances. It can be a matter of life or death. No matter how well-meaning doctors may be, the only person who can make that final decision of whether to continue treatment is the person whose life is at stake, and we as caregivers and loving relatives need to be sure of what that decision would be.

Wednesday, February 10, 2010

A Cat's Eye View

Baxter here. I'm FINALLY back. I've been waiting to Post Something for Days, but my Female Human has been Missing in Action.

I mean, she told me she was Retiring and I thought that meant I would have LOTS more time to Blog and to sit in her Lap having Quality Time. Instead, she gets up and she and the Male Human do the same things they did during the Week as they did Before. They walk That Dog in the morning and eat Breakfast and then, three times a Week he drives off someplace for the Day. Then my Female Human finishes her Coffee and Reading the Paper, and then Showers and goes off for the rest of the Day just like before! She tells me she is going to a place called The Hospital to visit her Mother and Aunt. Maybe it's like a new kind of Work. All I know is, she hasn't had time to Help ME do any Typing for Weeks now! So of course I have been Annoyed.

But finally, thanks to a Big Snowstorm, she and the Male Human are both Home for a change. And I finally get a chance to Have My Say.

First of all, the most Amusing News Story is the one making the Rounds about that Sarah Palin person writing something on her Paw so she wouldn't forget to say Stuff at that Tea Party place she was speaking at.

The NY Post article Linked Above contains a couple of great Quotes:


"Asked if she knows more today about domestic and foreign affairs than she did two years ago, Palin said, 'Well, I would hope so.'

She said she gets daily briefings by e-mail on domestic and foreign-policy issues from advisers in Washington.

'I sure as heck better be more astute on these national issues than I was two years ago,' she said."

Now, that's Kinda Scary. So the Human who was running to be "A Heartbeat Away from the Presidency" two years ago admits she was NOT "Astute" at the time?

Then, audaciously, she had the Nerve to say on her Talk Show,

"'I think that President Obama, with all due respect, his lack of experience is really made manifest in the way that decisions are made in the White House today,' said Palin."

This from a Woman who has to Write on her Palm things as Basic as, "Cut Taxes (with "Budget" crossed out), "Energy," and "Lift Spirits"??? A Woman who went to Something like Five Different Colleges before managing to Graduate? A Woman who admits to knowing Nearly Nothing two years ago when she Ran for Vice President?

It just makes Me want to HISS.

Excuse Me, I must Wash to Calm Myself.

OK, I'm Back.

Let's see, what Else have I missed?

Here's a good one (H/T to Ron Chusid of Liberal Values for posting This on Facebook, where it Caught My Eye):

The Virginia House of Delegates is scheduled to Vote on a Bill that would forbid Employers from implanting Microchips into Employees - ostensibly for privacy issues, but the bill's Sponsor also wanted to make sure that Something Else didn't happen:

"'My understanding -- I'm not a theologian -- but there's a prophecy in the Bible that says you'll have to receive a mark, or you can neither buy nor sell things in end times,' Cole said. 'Some people think these computer chips might be that mark.'"

Good going on that Separation of Church and State thing, Delegate Cole.

After all, WE all know from The X-Files that implanted Chips aren't the "Mark of the Beast," they're used by ALIENS.

On a Totally Different Subject, that was some Super Bowl game! My Humans went to a Super Bowl Party that they go to Every Year but I managed to see the Highlights. New Orleans went wild when the Saints won and gave them a Big Parade. You can see some pictures of it Here.

As for News from the Animal World, Best Friends Animal Sanctuary posted on Facebook that February is Adopt a Rescued Rabbit Month. If you click on the Linkage, it will take you to Best Friends' adoptable Bunnies. I don't usually Shill for Other Species besides Cats, since of Course as a Cat I would love for everyone to adopt Homeless Kitties. But Bunnies are very Cute Pets and I wouldn't mind Sharing a House with one. Better than That Dog, in My Opinion.

Speaking of Dogs, there was a Story a week or so ago about Vicious Beagles Terrorizing Long Island. As it turned out, the Viciousness was Highly Exaggerated. The North Fork Animal Welfare League said that although it is Sadly True that Hunters sometimes abandon their Hunting Dogs if they aren't up to Snuff as hunters, the Beagles themselves are friendly social dogs. Apparently the Story got out of Control, as Usual - one woman got Scared by a bunch of loose Beagles running up to her and said they were "Vicious." This is how Rumors about Dogs get started.

Now, as a Cat, I am not Fond of Dogs in General. But I still hope the Beagles, who have been Rounded Up, find Homes. Dogs may be Giant Pains in my Tail but they Deserve Homes.

That is the News for Now. I will be Back sooner rather than Later, I hope, and My Human will be back shortly as well. Until that time, keep your Catnip Dry and enjoy the Snow.

Monday, February 01, 2010

The End of an Era - and a New Beginning!

It's been awhile since I posted here, and I'm sorry for neglecting the blog world. But as of Friday I am officially a Retired Person and will have a lot more time to do whatever I want to do.

For the past two weeks, in the middle of my last month of work, my mother got sick and I needed to spend a lot more time with her. She had an infection that needed intravenous antibiotics, and after 9 days of going to the doctor's office for her infusion of antibiotics, she developed a lot of swelling in her legs and was becoming weaker and weaker. I finally had to take her to the emergency room of the hospital last Tuesday, and she was admitted due to electrolyte imbalances and abnormal kidney function.

She's doing much better now but will likely be in for awhile longer, and then into the rehabilitation section of the hospital, before she gets to go home. Since she's been in the hospital, of course she hasn't been able to smoke, and I'm hoping she won't go back to it when she goes home! If nothing else, not smoking seems to help her appetite, and that alone is an improvement for her health!

During this past week I also developed a rotten head cold which left me without any ambition to do anything...and kept me from fully absorbing the fact that it was my last week of work. My group took me out for a lovely lunch last Monday, which was fun, and then there was a nice retirement party for me in the lunchroom on my last day. It was touching and I will miss everyone I've known there.

So here I am, officially retired. So far it doesn't really feel that different except I keep reminding myself it's not just a temporary break - it's permanent. I'm free to go sit in the hospital with my mom, which is where I am now, and I'm free to meet friends for lunch, dinner or something in between, without worrying about a meeting coming up on my calendar.

Of course, I will also be free to do more of the housework, more of the dog walking, and other chores! But that is only fair.

I don't know yet what I'll be doing day to day but am looking forward to finding out.