Friday, June 28, 2013

Checking out...and leaving, too, by god!

What I did before I left for the weekend

Visit mom
Talk with nurse about her release 
I.e. need walker
Check on meds and other instructions

Buy groceries
Sushi for m
Orange juice and yogurt for mom
Ice cream for both
Cat food for piper

Get new prescriptions
Pain pills
New antibiotic

Water plants

Fill bird feedeers

Check the mail 
Shred mom's junk mail

Change her sheets and towels and clean her room and bathroom
Lay out clean p.js. 

Give m instructions re this and that
Write notes to m re this and that
Write notes to self re this and that

Take homemeade bean soup and spaghetti sauce out of freezer

Make bed
Make 2 out of 3 shuttle reservatioins
Check infor flight
Charge ipad and phone and camera

Notice that if feels good to have a break
Love the the fog as it rolls inland and know that I will be back
Freak out a little when I hear "Hotel  California"  in the shuttle to LAX.

Wednesday, June 26, 2013

A Brief History of My Mother's Hospital Rooms

I remember every hospital room my mother's been in--except for the first time she almost died. I was a toddler then, but heard the story many times. How my father rushed her to the hospital one evening and was told that her exploratory surgery would be at 9:00. He went back to his grocery store, assuming they meant 9:00 a.m. When he arrived at the hospital the next morning to be with her before she went under the knife, he found my mother recovering from major surgery to remove a tubal pregnancy.

The summer after my freshman year of college my mother developed pneumonia and a staff infection after surgery to remove her gall bladder. I wasn't in great shape myself that summer. A year earlier I'd given my infant son up for adoption. My pregnancy had aggravated the curve in my spine and my ribcage was twisting toward my heart and left lung. I needed surgery, too, and was scheduled for a month-long hospital stay the following January, but my mother's condition was more dire. What I remember is the shininess of the hallway where I was allowed to stand and talk to her. From that perspective, her isolation room seemed unnaturally deep, and the view out her window stretched forever into the green Iowa summer. If my mother died, I'd be expected to quit college and raise my younger brothers. This would be God's way of punishing me, I thought, for giving up my baby.

I was in my twenties when she had her first lung tumor. I flew from Los Angeles back to Iowa to see her. Her room was near the nurses' station and the kitchenette where ice and juice were dispensed was nearby, too. Her pain was excruciating, and I shuttled back and forth, asking the nurses for pain medication and permission to serve my mother a glass of juice or ice water while I craved a good stiff drink.

There were a dozen more minor procedures in the following decades. Stents, angioplasties, hernia repairs, minor cardiac procedures, cataract surgeries. By that time, my mother had moved to the east coast, and I was a continent away with children of my own. With the exception of a heart procedure meant to shock her misfiring heart into a more regular rhythm, I missed all of it.

My children were grown by the time the second lung tumor appeared. I was still on the west coast, but I was divorced and living alone. The removal of the pea-sized squamous cell tumor would require five days in the hospital, she told me. I planned to arrive on the east coast on day four, bring her home from the hospital, and spend a week with her as she recovered. Her first room in Washington Hospital Center was dark and cramped, and her bed was just a foot or two from the door. The morning I arrived to take her home, the crisis team was huddled over her. My mother looked terrified as she struggled to breathe through the oxygen mask pressed against her face. A petite woman in a white coat whisked me out of the room and told me my mother was being rush to ICU where she'd be put on a ventilator.

I spent the next month living in the guest quarters at WHC. My room resembled a slightly run-down 80s motel, but there was a laundry room, a microwave oven, free coffee, and a bank of vending machines that kept my self-soothing M&Ms habit well supplied. My mother's ICU cubicle, whirring like an engine room, was directly across from the giant control station where some ridiculous person sat at an elevated console answering the patient call buttons. "May I help you?" she'd respond in her polite and perky voice. I was polite and perky in return the first time I explained that my mother could not speak due to the ventilator tube rammed down her throat. The many subsequent times the voice responded to the call button in this manner, I assumed my psycho ax-murderer voice to repeat the explanation. Sometimes I simply shouted, "Get someone in here right now!"

The room my mother was transferred to after nine days in ICU was just as dark and crowded as the one before her breathing crisis. Finding it impossible to move forward head on, the nurses tended to every task by sidestepping between bed and walls, i.v. poles, and monitors. A nurse and an assistant performing a task together required a sideways duet that made them look like a pair of waltzing crabs. My mother's roommate had pressure ulcers and wept in her curtained bed so close at hand that it seemed criminally cold-hearted not to tear aside the curtain and comfort her.

After a week or maybe two, my mother was transferred to a slightly more spacious private room. There was a window that looked down on a courtyard, and I remember the day we finally stood together and looked down at the trees and benches. Not long afterwards she was released to a skilled nursing facility and managed to spend eight hours there before experiencing chest pains. She was transported by ambulance to Baltimore Washington Medical Center.

BWMC was the Ritz compared to the decaying inner city hotel ambience of Washington Hospital Center. While my mother was trapped in her spacious room getting sicker and sicker, I took breaks in the glass-topped atrium coffee shop, swilling caffeine and getting more and more agitated over the fact that I was about to lose coverage under my ex-husband's medical insurance. "My mother's dying and you're putting me through hell," I howled to an Aetna representative explaining for the umpteenth time that Aetna had all my medical records since all I was trying to do was switch from a group policy to an individual one. As I stood in an expansive hallway looking across a neatly mowed lawn into a row of trees explaining my woes in a phone call to a friend, she took charge and somehow convinced my ex-husband to keep me covered a month longer.

Before that month was up my mother was released from the hospital and Aenta approved my individual policy. I returned to L.A. and, after a stint in another nursing home, my mother moved in with my brother and his girlfriend in suburban Baltimore. Near the end of summer last year, she moved across the country to live with me. She's been an outpatient in two different surgical centers since her arrival here, and I've driven her to the emergency room twice. Yesterday morning she was transported to the ER by ambulance. That afternoon was her first admission to a hospital in southern California. A stay in the hospital is never like a hotel vacation, but given the jubilation I felt yesterday when my mother survived her latest crisis, this room with its ocean breezes and view of the mountains seems like the best destination this side of paradise.

Monday, June 24, 2013

If I fall, I might not get up

The good things about today:

I woke up feeling great.
There was time for coffee before I took the man who loves me to the train station.
My mother's doctor had an opening for the follow-up appointment recommended by the ER doc.
I walked on the beach while I worked out the details of that appointment.
I found lots of beach glass while walking and talking.
The doctor's office had a wheelchair.
The blue heron came to the boat dock this evening.

The not-so-good things:

I took the man who loves me to the train station.
My mom is still feeling unwell.
One of her antibiotics made her nauseated and we had to drive to the Dr.'s office with a dishpan in her lap.
She left the doctor's office for a 2nd doctor's office in a wheelchair.
She still needed the wheelchair to get back to the car.
She has new antibiotics and an anti-nausea drug.
She's had a little dinner and some Gatorade.

So there you have it. The scorecard for today. It looks pretty even. But it doesn't feel that way.

Sunday, June 23, 2013

Report from Pillville: Facial Cellulitis

The phrase "opportunistic secondary infection" popped into my head when I took a look at my mom after my return from the gym Friday morning. I think the term is mostly applied to the immunocompromised like those with HIV, but I'm guessing my mom's immune system has a couple hundred thousand miles on it and isn't quite running like a top. Things had been pretty swell here in Pillville with the circulation restored to her feet, and the digestive ills much improved, and the CPAP sorted out. There were little things--like the irritated nose from the oxygen cannula before we finally found the right CPAP mask. There was a spot on her left cheek, then another one, but they healed--more or less. Maybe the plastic from the mask was rubbing her face, we thought Then came a bigger spot on the other side of her face on...was it Wednesday? Thursday she looked a tiny bit worse but assured me she was dabbing the spots with peroxide and neosporin. Thursday night she abandoned the mask for the oxygen cannula.

Friday morning she was still asleep when I left for the gym. I phoned the doctor about a minute after I walked in the door. Yes, the doctor, a geriatric specialist, had an opening. He prescribed an antibiotic, said it didn't really look like MRSA. Are we all going to die? the lovely M asked later. Earlier on the way to the doctor, my mom said she would be really upset if she didn't make it to her birthday, and it occurred to me once again how vulnerable she is at her age with her laundry list of health conditions. Yes, a bump on her skin could be the straw that tips the old camel into the sand. I gave myself a little pat on the back for getting right on it.

Not so fast.

Saturday morning was a repeat. Mom sleeping. Me off to the gym.

Then I come home from the gym. While it would be an overstatement to say the elephant man's sister was standing in my kitchen, the fact was she looked much worse. Pink was now purple. Swollen lips. The healed spots coming back. A new patch of swollen pink creeping down her neck. Her throat was sore, she said. And she had a headache. And maybe the toothache where she had the root canal was back. "Hey, how about you get dressed and we go to the emergency room?" I ask. "No big rush, but when you're ready, let's go." So we go. Three hours later, she has a diagnosis of facial cellulitis and a prescription for a second antibiotic. Really important to nip this in the bud, the ER doc said.

Today things are improving slowly. She can't chew because she can't wear her upper plate and is sustaining herself ice cream smoothies, but the sore throat and headache are gone. The man who loves me is here with a new cocktail recipe that seems to be an effective prescription for me. So it's Sunday in Margaritaville. The warring city state of Pillville is threatening to overtake us, but we have a new thrift store cocktail shaker, and I'm about to lay in a new supply of ice cream. We have a barbeque and a piece of fresh caught yellowtail. We have classic movies on the iPad--close-captioned for my mom. We have so much good stuff here, we ought to set up a stand in the front yard and hand out samples to passersby.

But that said, people, the bear is back.

Friday, June 21, 2013

In the morning I can hear the earth breathing

Some mornings when I walk along the beach
twenty or thirty minutes might
pass, and I'll realize I haven't even looked at the ocean.
I'm too intent on looking for treasures in the sand, and I think
then of how I can lie in a lover's bed, back
turned and, still, his breath fills my body just as it fills his own.
Waves roll in and out whether or not my
eyes sink into the blue-gray-green, and without
knowing how this magic occurs, the sea and the earth under
this sky and I become

Thursday, June 20, 2013

Blessing the Beauty

Margaritaville has been bursting with beauty this spring. Herons swooping in nearly every day. More stillness than wind. Mother Nature has perhaps misplaced her calendar because there's been very little of the typical southern California June Gloom. Some evenings, there's barely a ripple on the water, the air soft.

Beauty indoors, too.

And beauty looking in from the outside.

Complete deliciousness, all of it--

in this place I call Margaritaville.

Wednesday, June 19, 2013

Friday, June 14, 2013

Wonders and Abominations

Just in case you're wondering where to hire a band of pirates, I happen to know.

Now we need some knights for the beach jousting tournament.

Perhaps they can ride pelicans instead of horses.

The folks who left this behind at their last beach gathering aren't invited. The bottles and cans were left scattered across the sand--not tucked into this box.

Perhaps the same crowd left this memento. The photo doesn't quite capture the strategically placed shoe-print.

I always hope that monsters find a more civilized self buried inside. And that reminds me. Want a great beach read? Try this.

I read it ages ago and find myself in the mood for it again. Here's an excerpt from the jacket copy:
"...all the elements for a TV horror movie: unnatural sex, a demon lover, a King Kong aspect, a typical movie car chase ending in a fatal crash, a hint of the jasmine of Madame Butterfly, and even an ozone-like whiff of E.T. 

Thursday, June 13, 2013

State of the State of Margaritaville

The girl has gone. The girl's mother and her siblings, having come to retrieve her, have also gone. But before that, there was a boat ride attended by a mega pod of dolphins. Literally thousands of them. Though I did not manage to capture any of their leaps on that day of beauty and wonder emerging from its gray skies. Next time I will video.

There was also a tea party during which I channeled Maggie Smith and asked to be addressed as Granny.

There was a trip to the local children's museum where girls got ridiculous and ants got industrious.

Seriously, if I had one of those Ant Works things, I would never get anything done. Then again, maybe it would inspire me to work harder at everything.

The gift shop at the children's museum sells fabulous handmade wooden toys and a local label of refried beans.

I totally wish I'd bought some.

The report from Pillville is quite encouraging. My mom's foot is not causing her any pain, and the latest angioplasty has officially been declared a success. At her latest visit to the gastroenterologist, she weighed in at 120 lbs. The skeletal look is gone. And she's sleeping better. The visit from the great-grand children should be bottled as a miracle cure. 

My friend Paula arrived for a visit just a couple of hours after the grandchildren and their mother left. Paula and I met on a trip to Greece in 2009. I was still a complete wreck, mourning the end of my marriage.

We had an amazing chat tonight as we sat in front of the fire chasing away June gloom's chill. The chat revealed to me that I am over my divorce. I was somewhat stunned by that realization. Divorceville seems so very far from Margaritaville now--as though it was an ancient lost city, a defunct civilization with a dead language, inundated by the sea lost forever beneath the waves.

Thursday, June 6, 2013

Day of the Awesome Pants

I'm not sure how we got onto the subject, but I asked the girl if she had a favorite expression, and she told me she liked to say "Awesome pants!" My current favorite happens to be "Cool beans!"

The photo above does not do justice to how completely filthy our pants got today. How did we get so dirty? We climbed over this fence.

I should, of course, add that we were invited and, in fact, assisted in climbing over this fence by an uniformed environmental scientist who was surveying the area for snowy plover nests. The girl and I walked up to the fence to read the sign surrounding a portion of the dunes and struck up a conversation with the young woman with the awesome pants job. The girl and I then went on our way to hunt beach glass, but upon our return, the environmental scientist called to us and told us she'd found a nest with an egg in it, and did we want to see it?

Of course we did. As we marveled upon it, I asked why the egg was left untended. "The bird will return to lay a couple more eggs," the scientist said, "but won't start incubating them until all the eggs are in the nest. That way they all will hatch at the same time." She also told us that once the plover chicks do hatch, they set right to work hunting for sand fleas. They do not need to be fed by their parents. "They look like little cotton balls on legs," she said. "The first time I saw one I was hooked!"

As the girl and I walked back to the car, we saw a pair of snowy plovers dashing across the sand. We speculated that maybe they were the parents of the egg. And we talked about what an awesome pants job it would be to walk around in the sand dunes looking for the eggs of an endangered species.

Four Generations Inhabit Margaritaville

It's grand daughter week here--a repeat of our inaugural week last year. Except that it's not a repeat at all. The girl is a year older and a mile taller. And it's so very different now that the great-grandmother is living here. An 11-year-old's top vacation picks probably do not include shuttling to a neurologist to discuss memory problems and dementia, nor a trip to the podiatrist to consider the ravages of bad circulation and the clipping of a well-weathered set of toenails, but these are among the things we've done. I've held to my own fitness and sanity maintenance schedule as well, so the girl has accompanied me to the gym for yoga and line dancing. Yet to come, she will see a session of t'ai chi chih where she will hear all about the chi--kind of an amazing thing for someone who is 11. If I had heard the word chi at 11 when I was growing up in a town of 3000 people in Iowa, I might have thought it to be a nickname for a cartoon animal from far-away Mexico.

Of course, we've done other things, too. The girl is a devoted beach walker, and the beach glass harvest has been plentiful with the added bonus of dolphins leaping in and out of the water when we raise our eyes from the sand to the sea.

We've added to my collection of heart rocks and lugged home other found treasure.

Part of the delight in bring home these treasures is the reaction from my mother. An inveterate trash picker when she was able to walk the streets of Baltimore to seize gold watches, amethyst rings, fine china, original art, boxes of clothes, and countless other useful things, she exclaims on anything we bring home as if it's the wonder of wonders.

There's also been swimming in the ocean.

That tiny speck of a head is the girl.

And there's been swimming at the yacht club (which I can no longer afford to be a member of....but a contract is a contract, alas.) And in any event, the sky looked like this.

One of the generations here in Margaritaville is here only nominally. M has a canvassing job this summer and works ridiculous hours with an insane commute. We miss her. Her absence and the girl's constant presence point out to me the similarities in their demeanors--sunny, talkative, anything but shy. I would not describe myself as such. The girl's father needs solitary time, as I do, and as my other daughter, C, does. We're fun. We're funny. We can party, but we don't seem to possess the same ease. When I told C that M was canvassing this summer and had to accost strangers on the street and ask them for money, she told me  how she had once volunteered to clean up bright orange vomit rather than stand on the dock and call out to passersby that there were still tickets available for the boat's next cruise. Yeah. Totally phobic about bodily functions, I would have elected to simply jump off the dock.

So here I am again. With history repeating itself and my own little extrovert at my side. Sometimes life is incredibly kind.

Where do you, dear readers, fall on the extrovert/introvert scale? Clean up vomit? Ask strangers for money? What would you choose?

Saturday, June 1, 2013

Report from Pillville: the angioplasty, the pain meds, the attitude, and the sounds that prevent silence

My mom had her second California angioplasty on Thursday. I have no idea how many stents she brought with her from Maryland and how much arterial plaque she left there, but since her arrival here in California she has added to both. Bad circulation seems to run in my mother's  family, but with all of the smoking and the breathing of second-hand smoke, it's hard to say what is truely genetic and what is tobacco-related. Still, when you have two siblings who've suffered amputations, it's time to sit up and pay attention.

 My mother's right foot began waking her up several times a night a couple of weeks ago, so we moved her regular appointment with the vascular surgeon up three weeks. She's less sore after this angioplasty than the last one, but despite the fact that the doctor reported that her circulation was much improved, the foot is still bothering her. Two new types of pain meds have been added, so maybe the nerve endings will stop harassing her brain soon. My next suggestion will be an anti-depressant--but I'm not sure if it should be for me or her. I'm joking. Mostly. The anti-depressant I was on after my marriage fell apart is now marketed as relieving physical pain. You've probably seen the TV commercial with that poor woman struggling to get up off the couch while the voiceover says something like "When you're depressed, everything hurts." That was certainly true for me, and I found my daily pill more effective for the physical than the emotional pain.

One thing I've observed is that since the angioplasty and the new meds, the noises my mom makes have increased ten-fold. There are never more than a few seconds of silence here in Margaritaville now. She talks to herself, swears, moans, groans, growls, grunts, squeaks, and outright yells. Yet, though somewhat forgetful, she is entirely able to converse--which is the only time she's not making noise. What I enjoy most at this point is either talking to her or vacuuming. I have never been more grateful for my ability to sleep soundly.

So what this state of affairs is likely to yield, as I engage my mom in more conversation, is more stories.   Stay tuned. I'm looking forward to it.