Sunday, January 10, 2010

Body Art and Not So Smart

Richard has a CNA with a biohazard symbol tattooed on her arm. Thank goodness she was only taking his vital signs. I’m not sure Richard would have let her perform any intrusive procedures on him as freaked out as he was by that tattoo. She says her husband has a matching tat, and he’s jealous because she has more body art than he does. They give each other gifts of more body art for special occasions. Ain’t that special?

When I asked Richard’s nurse to check his chart and make sure his immunosuppressive medication labs had been ordered, she said she had seen the order in the chart. She added that she remembered this because she didn’t know what the test was. Did she have to admit that to me?

Richard’s treating physician failed to round on him (probably because he’s scared of me), but called the room after I finally had him paged. He suggested that Richard should get a primary care physician not affiliated with his post-transplant team. His rationale is that he doesn’t think the post-transplant team would care enough about routine procedures like colonoscopies, and “We’d hate to see him survive a transplant and die in three years from colon cancer.” Once again, he opened his mouth and inserted his foot.

After the huge investment made in transplant patients, nobody gets as much preventive care as post-transplant patients being followed by specialized teams of professionals trained specifically in post-transplant care. How does the hospitalist think Richard has survived for the eight years since his transplant?

Then again, as educated as Richard is, he sometimes says things that aren’t so smart. When I was leaving for Atlanta after our holidays in the holler, I told him that I thought he would enjoy all the peace and quite of our house without any company, and that my absence should add to his tranquility. His reply was, “Oh, you’re just background.” I reminded him of this statement when I got back. He must have thought I wanted a deeper understanding of what he meant because he replied, “You know, like the dishwasher or washing machine.” No wonder he only pays attention when I’m overflowing.

As I prepared to return to the hotel, I pointed out that I didn’t think any of his current nurses were a threat to me when I was away from him, as none of them seemed particularly cute. Richard replied that he thought some of them were nice looking, and he added, “But then, again, I’m sixty-six years old and anything looks good to me.” I guess I won’t get too atwitter next time he tells me I look nice.

I’ve already had to instruct him that a man should never call his woman a big strapping girl. He has also had to learn that women don’t snore, they only breathe loudly; and, while women may pass a bit of gas, they never fart. With such a poor education in the ways of women, is it any wonder Richard was a bachelor until he was forty-nine years old?

Saturday, January 9, 2010

Maintaining Memories

Our House in the Holler is Richard’s Tennessee Mountain Home and my retreat from my crazy world. The people of Coker Creek are our people, as are the people we’ve collected along our separate lives and our lives together. Our challenge is to make new friends while keeping the old. They are all gold to us.

We bought our home in the holler without knowing anything about Coker Creek. We didn’t know that it’s in a dry county where beer isn’t considered liquor, but wine is. We didn’t know that the closest mid-sized grocery store is twenty-three miles away. We didn’t know that the closest restaurant is eleven miles down a steep, serpentine mountain road. We didn’t know that the closest ethnic restaurant is a Mexican one that doesn’t serve margaritas or any other alcohol because it’s in a dry county. We also didn’t know that the most exotic ingredients you can buy within an hour’s drive are Americanized Italian, Mexican and Chinese foods.

Something else we didn’t know is how community oriented the folks are and how much we’d be welcomed into their hearts and homes. As conservative as people tend to be here, I was afraid that I’d be burned at the stake. Instead, people seem to find me amusing, and they love salt-of-the-earth Richard. Even though he is so smart and considered a bit quirky in the city, he fits right in in Coker Creek.

I didn’t want to make any more friends. I already feel guilty for not keeping up with the friends I have. Now, here we are several hundred miles from our old friends with a whole bevy of new friends. It wouldn’t do any good for us to run away. We’d still love these people and they love us, so we’d be leaving a part of ourselves behind if we left. And I’d want to continue contact with all of these people.

Richard doesn’t seem to suffer from separation guilt or anxiety. When people are gone, they’re gone. When we move, his philosophy about our former home seems to be, “That was then, and this is now.” I like to drive by and see our former homes and reminisce about our former lives. I also like to hear from old friends, no matter how long we go between visits. Richard wants to close the door and never look back.

He says he didn’t grieve when, at age thirteen, he lost his father because his father had become a part of him.Whenever we’re making memories and I want to take a bunch of pictures or buy souvenirs, Richard tells me that he doesn’t need either because he’s doesn’t have Alzheimer’s yet. Maybe the reason he knows so much is because every experience he’s ever had is stored in his rapid-access memory. I guess my memory and my imagination just aren’t as good as Richard’s.

The only thing we have left of yesterday is the memories; when we turn off the tapes of our memories, we lose that part of our lives. I have had one of the richest lives of anyone I know. I won’t go forward without recalling what came before.

I don’t know how we’re going to resolve all the conflicting emotions plaguing us right now. I do know that we’ll have to say good-bye to Richard’s Tennessee Mountain Home and my House in the Holler unless we can find a way to get proper emergency care for Richard. For a manly man, he’s delicate, you know.

Friday, January 8, 2010

Patient Persistence

How am I supposed to react when the nurse comes into Richard’s critical care hospital room and announces that the pharmacist recommended a change in antibiotics because the first one could affect his heart, and followed with the announcement that Richard’s swab showed positive for Methicillin Resistant Staph Aureous. Now, I don’t think these things are good when one has a normal immune system, but I’m pretty sure they can be extra problematic for people who are on immunosuppressive medications.

I felt worse after talking to Rachel, who encouraged me to check with Richard’s post-transplant care team. I actually succeeded in getting the on-call post-transplant doctor to talk to me and agree to take a call from the hospitalist treating Richard. I felt greatly relieved -- until Richard’s nurse told me that the hospitalist refused to call the post-transplant doctor.

My misgivings were compounded when I found out that the nurse for the night had some experience with post-transplant care and confirmed my fear that the level of immunosuppressive medication in Richard’s bloodstream was not being tracked. This was especially worrisome in light of the fact that less than a month ago the post-transplant team had changed Richard’s dosage because his levels were off.

Richard has had rejection issues in the past, so I’ll do anything necessary to prevent a recurrence. The night nurse agreed to suggest the required lab test to the doctor. I realized there was nothing more I could do until morning, so I went to bed.

Just as I was entering the twilight zone between awake and asleep, Bub called and put Elaine on the phone. Elaine, being a pulmonologist, and one of our very best friends, was not happy with the report I gave her. Upon waking, I went back to the hospital -- armed for bear.

Lo and behold, the doctor with whom I was having the problem was no longer on call. I had to start the whole patient advocate routine with another doctor, who sent a nurse out to talk to me. The nurse was a different one than the one who had helped me the night before. Once, again, I explained my misgivings. Once again, the nurse asked me questions, the answers to which they should be getting from Richard’s post-transplant team.I went to the critical care department manager and pled my case. She reported that the doctor would come talk to me. I made it clear that I had no desire to speak to the doctor until he had talked to Richard’s post-transplant doctor.

Three hours after my arrival at the hospital, I had still not been allowed to see Richard, nor had I seen his doctor. I went to administration, where the hospital risk manager took over talking with me. By this time, I was very controlled, and very angry. Is it too much to ask that our healthcare professionals admit when they aren’t experts on something and make a phone call to the experts -- or transfer the special needs patient to a special needs facility?

One of Richard’s favorite sayings is from Proverbs: He who knows not and knows not that he knows not is a fool; avoid him. He who knows not and knows that he knows not is a student; teach him. He who knows and knows not that he knows is asleep; wake him. He who knows and knows that he knows is a wise man; follow him.

The hospital is a very pleasant facility, with a home cooking cafeteria and wonderful nursing care in CCU, but unless the doctors and administration recognize what they don’t know, I plan to shun them and this hospital.

Thursday, January 7, 2010

Balanced Blessings

The good news was that I spent my first day back in the holler in my pajamas in front of the fire.
The bad news was that I was still unshowered and in my pajamas when Richard asked me to take him to the emergency room.

The good news was that Richard didn’t feel sick enough for me to call the EMTs.
The bad news was that this meant I had to drive after dark on our two-lane mountain serpentine roads.

The good news was that we had enough gas in the tank to get us to the hospital.
The bad news was that when Richard was finally settled in CCU, at 2:30 in the morning, my car wouldn’t run because I had no more gas in the tank.

The good news was that I was in a well-lit parking lot.
The bad news was that it was less than twenty degrees in that parking lot.

The good news was that we have AAA roadside assistance coverage.
The bad news was that the tow truck arrived without a can of gas.

The good news was the tow truck driver said he’d tow me to the nearest gas station.
The bad news was he couldn’t position the tow truck properly to tow my van out of its parking place.

The good news was the tow truck driver was able to shake the van enough to shift sufficient fuel to the engine to back the car up.
The bad news was that was all the gas the van had.

The good news was I had a credit card.
The bad news was the tow truck driver had a gas card that didn’t work.

The good news was there’s a very comfortable hotel not very far from the hospital.
The bad news was the desk attendant forgot to give me the hospital patient family discount.

The good news was the hotel provided toothbrushes, toothpaste and deodorant.
The bad news was I didn’t have a change of clothes or underwear.

The good news was there’s a WalMart close by where I purchased a change of underwear and clothes.
The bad news was that the need for these items was precipitated by Richard having to stay in CCU, and icy roads here and in the holler.
The good news is the doctors are treating Richard’s pneumonia.
The bad news is they didn’t coordinate with his post transplant care providers before doing so.

On balance, I’d say the good outweighed the bad.

Wednesday, January 6, 2010

Rollicking Retirement

As we closed the door on our last set of guests, l began getting ready for my television interview with Marcia in Chattanooga. She’s starting the new year with a program on starting over, and feels that I may have some insights into this topic worth sharing with her fans. How can anyone say no to a woman who used to be “Miss Marcia” on Romper Room School? She taught millions of kids how important it is to be a “do bee” and to reach for the stars. I certainly took those lessons to heart, and am thrilled that “Miss Marcia” wants to talk to me.

By the time our guests leave, I’m always rung out, physically and emotionally; but my spirit is super-charged. These are the times I have to be careful; after going ninety to nothing for weeks at a time I’m prone to planning too many new projects while in my supernova state. The best way to avoid that is to lie down for a while until the urge to orchestrate passes.

I already have so many plans for the new year that I’m raring to begin. In addition to the television interview, there’s the book I’m writing with Mamie, and the retreats I’m planning with Gayle and Julia. There are cooking and craft classes to be gotten together with Holly and Josie. Aunt Mabel wants to write a Cajun cookbook with me. Jack has another set of stories to get published, and I’ll need to set aside time for my books in the works. Thank goodness, Camille is talking about becoming the business end of my various ventures; I’m hoping that Suzanne comes through as my typist.

Between our Holidays in the Holler and Ms. Marcia, I went to Atlanta to take Rachel and the girls on a Christmas gifts exchange shopping trip. On the way back from Chattanooga, I got a call from a woman wanting me to write and publish a book about her heroic police captain son killed in the line of duty. I couldn’t wait to get back to the quite of Richard and our Tennessee Mountain Home to begin sorting all this out. We still have to de-Christmas our house, but that can wait. After all, tomorrow is another day.

I’d love a couple of days without a plan. It seems like forever ago that I meandered through a day, letting things just happen, come what may. I’m hungering for a long, lazy day of being snuggled up in my big bed with a book, or one of those cold rainy weeks when I do nothing but sit tapping away on the keyboard in front of the roaring fire. But, maybe I’ll have to wait until I’m dead to have that much down time.

Tuesday, January 5, 2010

Hunting In the Holler

When Rachel’s family comes to visit, they sleep in an outbuilding that Larry used to call the “rat shack” because what we thought to be rats’ nests covered the space between the ceiling and the roof. The building had been abandoned by all but the rodents for some time before we bought our Tennessee Mountain Home. Rachel insisted that it could be turned into a nice cabin, which her family proceeded to do, putting up insulation and wall boards, and furnishing it with bunk beds and country curtains. They now lovingly call it “Morrissey Manor.”

Rachel and family hadn’t been to their little cabin for many months, so the critters, once again, set up house keeping in the overhead crawl space. Upon the Morrissey family’s arrival, they discovered that all their linens had to be laundered to remove liquid golden gifts that had streamed down the walls onto the air mattress. Rachel changed the sheets while Larry packed the spaces between the rafters with poison pellet packets; and they called it a night.

The family finally got nestled all snug in their beds, when the “rats” declared war. Larry jumped up, determined to eradicate the enemy. With much fanfare, he began tracking the rodents, giving frequent updates to Rachel, whose only wish was a bit of sleep. Larry was determined to identify the intruders, so Rachel suggested that he photograph them to keep her from having to go into the below freezing temperatures on rodent patrol.

The next morning, a bleary-eyed Rachel reported all of this while we waited for Larry to appear with pictures of his prey. It turns out that the rodents were squirrels. Scott immediately got online to identify the type of squirrel – flying-- and the best method for disposal. It was now time for a Lowe’s run to get a trap. Scott became the great squirrel trapper while Nick wished that the rodents would turn out to be chinchillas, so we could make some money on the ordeal.

Meanwhile, Rachel sent Miya and Sarah on dead rodent patrol, afraid that one of the five dogs in residence may eat a poisoned pest. The outside of Morrissey Manor looked like a picnic ground. It seemed that the squirrels had greatly enjoyed their feast, but didn’t want to litter their space with the empty packets. The bright yellow paper was strewn all along the area of the entry door. There was no sign of the squirrels, alive or dead.

Scott and Richard returned with a squirrel trap, and Scott baited it with peanuts. The following morning, the peanuts were gone, but still no sign of Rocky the flying squirrel. Miya suggested that since they were flying squirrels, maybe they flew in, grabbed the peanuts, and flew out; and that’s how they avoided tripping the trap.

Such excitement! That’s the closest to a big game hunt we’ve come at our House in the Holler.

Monday, January 4, 2010

Auld Lang Syne and Then Some

If the septic system crisis didn’t put a damper on our holiday hilarity, we certainly weren’t going to let a little drizzle dampen our demeanor. All nine kids, ranging in age from eight to eighteen, set up a “beauty” salon in our master bedroom and bath, where they went through a pint of Richard’s hair gel creating weird and wondrous hairstyles on both boys and girls.

As the house filled with even more people filling every chair in the house, many of us moved outside. At least the night was relatively warm; and Nick and Albert had built a huge bonfire. This was in addition to all the firewood they worked with Richard to cut and stack for both indoor and outdoor blazes. The kids moved outside to play hide-and-seek in the woods and shoot fireworks while the adults monitored them from the fire pit.

Our living room was filled with folks listening to David’s guitar in front of the fireplace. The guest/playroom was an escape for cousins who had much catching-up conversation to share. Our kitchen contained more conventional fare than that which we served at our first New Year’s Eve bash in the boondocks. That year, Scott brought up sixty pounds of fresh gulf shrimp and his boiling rig. We rang in the New Year with Cajun boiled, head-on shrimp and all the fixin’s on our deck. Several of our guests couldn’t bring themselves to eat food that was looking at them.

This year, we had Rachel’s jambalaya, cookies, and artichoke squares, which we brought back from her Christmas open house. I used left-over Italian mushroom squares made by Rachel to create an Italian frittata, which we served with marinara and parmesan cheese. Buffy and Rachel helped prepare chorizo and cream cheese-stuffed pickled jalapenos, much like Holly had served us several months ago. Rachel and David were greatly relieved that most of the mountain folks found these too hot for their tastes, leaving most of the peppers for them. I suppose we’ll never have a holiday happening without a little Cajun cuisine.

I reinvented a favorite 1970’s mushroom in dilled sour cream hors d’oeuvres recipe which we served with garlic panatini. Buffy requested this recipe after one taste. We also had various cheese balls and spreads to go on crackers and chili-cheese stuffed banana peppers. To round out the menu, Buffy poured barbecue sauce over Little Smokies, and Rachel sliced the fruitcake that I had made in her honor.

It’s traditional in the mountains to replace the ball drop at midnight with a possum drop. Charlie takes care of this detail. Full disclaimer: There are no animals harmed in this ritual, as Charlie’s possum is a fluffy stuffed animal that usually hangs in his saloon.

By the time we toasted 2010 with champagne, both real and non-alcoholic, and Charlie dropped his possum from the dog run, we were all covered in mud from slipping and sliding in the drizzly rain. I had fallen almost into the fire pit, taking Deborah with me. Camille had bruised her butt taking a tumble down the muddy stairs, and Albert had slid into home plate on our front porch. Thankfully, no serious injuries were sustained, but I guess Richard can add slip-proofing our deck and stairs to his New Year’s honey-do list.