Stay Away or Be Betrayed By A-As-In-Hole Insurance Company

When my mother had her April Fool's Day stroke her left side was affected. Her left leg and left arm would not work and she could not swallow food. On the twelfth day of April This City Hospital inserted a plug tube in through the stomach wall to allow feeding via of a nutritious if ugly brown liquid from a bottle.

On the thirteenth day of April the Hospital shipped her off to Sunset City supposedly for rehabilitation.

And rub-a-dub-dub she did get rehabilitation from three therapists at this hub, The Physical, The Occupational and the Speech.  Speech is a bit of a misnomer for my mother's talking wasn't at all affected by her stroke. She could speak as well as ever. But Speech Therapy apparently covers all things mouth and throat and this therapist was there to help her regain the ability to eat real food again.

These therapies were doing some good. My mother was regaining movement in her left leg, to the extent at least that she could move it back and forth and reposition it in bed. The left hand was the stubborn part. From the beginning she could raise that arm, but her hand stayed immovable with the fingers squished together. The best that had happened after 39 days of therapy was a slight wiggling of her fingertips.

However, her swallowing was quite another story and in some way the swallowing was the most important of the therapies. If my mother could regain her ability to eat real food it would increase her quality of life immensely even if she did remain handicapped in her extremities. If she could not walk again she would at best be able to enjoy the taste of her favorite foods. This would also allow her to be more mobile, albeit with the use of a wheelchair. It was difficult for her to be moved with the feeding tube. Without it she could be taken to have meals in the cafeteria with other residents, enjoy a meal and perhaps some conversation.

By the 39th day she was eating selected foods such as yogurt and pudding. However, on the 39th day there was a great leap forward. On that day Sunset City took her to a Distant Hospital for a video digital scan of her mouth and throat. Distant Hospital had a far greater reputation in this field than This City Hospital, although my mother complained about them taking her so far rather than across the street.

The next morning I had an email from one of her friends that they had visited that night and she was eating a peanut butter and jelly sandwich. Whoa, I thought. If she can swallow a PB&J then can't she swallow everything? I have difficulty sometimes swallowing peanut butter.

When I visited the next day it was lunch time and mom was sitting up in bed being fed normal food, the menu item of the day for the noon meal, macaroni & cheese and a fruit salad. (She said she passed on the chicken as it was a bit chewy.)  She was also eating this straight up, just as you and I would eat. Prior to this to sup on a cup of yogurt she had been forced to turn her head to the left and down with her chin practically on her shoulder. This was to help force the left muscles of the esophagus to push the food along.

What they saw on that video scan changed things. My mother has a pouch in her throat. It is a pre-existing condition. Her personal doctor has recommended surgery a couple years or so back, but she refused because she didn't want to leave dad home alone while she was in hospital. Somewhat ironic as things turned out.

It is my opinion this pouch was more the culprit with her swallowing situation than her stroke. Nonetheless, on the 40th day of her rehabilitation she had made great progress within the last 10 days. Her left leg had become mobile again. She still couldn't "stand and pivot," meaning she couldn't walk, but the Occupational Therapist told me the problem was her right leg was too week to support the left. It was certainly possible with continuing therapy this might be strengthen enough to allow her to stand. If it couldn't she would be limited to a wheelchair, but people can propel a wheel chair with their feet and at this point that seemed a possibility. And she was now able to eat normal meals portending a time when she might actually be rid of the feeding tube.

Everything was looking good.

Then on the 42nd day A-As-In-Hole Insurance Company cut the strings.

On the Friday afternoon of Memorial Day Weekend they sent notice that they would no longer provide coverage for her therapy because she had plateaued, as they called it, and no progress was being made.

The insurance coverage ended on May 28 and so did her therapy and so did her eating of any real food.

TO BE CONTINUED

What Do You Fear, My Lady?

"A cage. To stay behind bars until use and old age accept them and all chance of valor has gone beyond beyond recall or desire." -- J. R. R. Tolkien

It is the Monday morning after the Friday evening before and my first of many visits back to Sunset City to see mom.

I roll dad into the room and the first words out of mother's mouth are, "Larry, you gotta get me out of here!"

"I'll try," I promised.

When I was a child I began to learn how to do magic tricks. But there is no such thing as magic, only tricks. Magic is optical illusion, deception, distraction and false panels. This was real life and no optical illusion. There were no false walls around my mother's bed. She was not a rabbit to be pulled from a hat. She was an old woman thrust suddenly into a system we seldom think of in the course of our lives. And she was a lady fearful of being caged away in Sunset City forever.

Sunset City was a closed system. Everything that had been in her outside world was exactly that -- outside. She couldn't be examined by her long-time personal physician. He had "no jurisdiction" in Sunset City, as a Sunset City manager put it. She had a new doctor, a stranger to her, someone who was under contract to visit the facility once a week and visit as many inmates as he could.

I called Dr. Whatzit at the end of mom's first week in this new world and asked about her prognosis. He was as optimistic as ever and said that she could eventually get off the feeding tube, but he then said he could give me no info about her condition. He hadn't seen her since she left the hospital. He couldn't visit her in the nursing home. If she came home again in the future, then he would be her doctor again, but for now the nursing home supplied her medical care.

I began asking about mom at Sunset City, trying to find someone who could give me some clear data about her condition, situation and future. Just as it had been in This City Hospital, it was like chasing a ghost. Maybe such a thing existed, maybe not. Finally I ran across a lady, the social worker, named Helen Hooters. I know, I know, terrible name for a woman to be stuck with. If that was her maiden name I can imagine the teasing she got growing up. (Helen Hooters is not her real name, of course, but her real name was just as bad, maybe even worse, and everyone you told it to would kind of smile and chuckle a little.)

She told me they would arrange a "Care Meeting".

In the meantime little tales circulated and found the way to my ears along with a growing chorus of, "You got to get her out of there." Problem is, I was never able to determine what was real and what was imagined.

On the first visit she said there was a young black man in her room, an aide of some kind, and he wouldn't give her her teeth. She asked several times and he wouldn't do it. Finally she rang for the nurse and the nurse came and handed her the dentures. Mother claimed the next morning she saw the young black man in the hall talking to a couple women who worked there. She heard him say he got fired. She felt she got him fired.

A couple days later she told people she woke up and thought she was having another stroke. She rang for the nurse and one came. Mom asked for a doctor. The nurse said, "We don't have any doctor here," then walked out of the room without doing anything and no one else came back in to see her.

But did these things happen? Remember in the hospital my mother saw strange woman talking in her living room one time and a mystery man entering her room in a wheelchair another time.

We brought up such complains at the Care Meeting and the Floor Nurse went out and checked the daily log and no such instances were recorded.

My mother's main complaints were the staff was rough on her when they changed her or moved her to make the bed. She would tell them it hurt, but they wouldn't stop. Yet, her condition was such moving her would hurt and some staff may have been more gentle than others. She and her friends who visited were annoyed because mom's requests weren't answered at once. Was she truly being ignored or were other duties more important at that moment to drop and attend to my mom's want?

I don't know.

We had the Care Meeting on April 26. A day short of two weeks after my mom was admitted to Sunset City. This was the first I got any input about what was going on with mother. It was almost comic. It was like a meeting of the United Nations to discuss some diplomatic crisis. I arrived with my dad in tow (or push as it was) and a friend of the family who they trusted. Helen Hooters came into mom's room at the head of a parade.

They trooped in, each saying hello as the formed a semi-circle about us, seven of them. There was Ms Hooters out in front (sorry, couldn't resist the pun) and then the Activities Director, the Floor Nurse on duty, the Physical Therapist, the Occupational Therapist and the Speech Therapist. I forget the function of the last woman. Heck, she could have been a patient who just followed along for all I know.

Each introduced themselves and explained their function. The Floor Nurse went out to check the daily log, as previously mentioned and promised to look into my mother's complaints. They did say that a report was filed weekly to the insurance company. As long as my mother was making progress, things would be fine, but that the insurance company could stop the coverage at anytime if it felt she had plateaued. They promised to fight against such a thing. They also said each therapy was limited by the insurance company to only twenty minutes a day. Remember these things, they will come up later in another post.

Finally, they trooped out and then the Director of Nursing paid us a visit. She assured up she would see that my mom got out of the bed more often and taken to activities.

Everyone had been very pleasant and professional, except perhaps the Floor Nurse, who just seemed nervous throughout. Or am I imagining things now?

At any rate the meeting was very assuring that mom was being taken care of. Still, the next time I visited mom's first words were, "Have you made any progress getting me out of this place?"

"I'm working on it, mom, I'm working on it."

And boy was I ever. This getting her out of there had become a 24/7 job with no benefits and no pay and a seemingly impossible goal. I had entered the Kafkaesque world of the Nursing Homes.

Well, Then How Do You Know There Is One?

"The Wizard? But nobody can see the Great Oz! Nobody's ever seen the Great Oz! Even I've never seen him!"


 Mother looked weary and mussed. She said, "They say my mouth is crooked."


She spoke much clearer than I had been expecting. There was perhaps a tiny slurring of a word here and about, but not much.


"Not very crooked," I said.


Dad sat down in a chair in the room. He was exhausted. I had pushed the chair near the bed. He took her hand.


"They say I had a stroke," she said, but she didn't know much else. She also kept drifting in and out of consciousness. She said something about them giving her morphine. When she floated back to us she told about the women.


"There were these women in my living room. I said, 'What are you doing here?' and they said, 'We're working.'"


Then she said, "Last night a man came in the room. He was in a wheelchair. I rang the bell for the nurse and she came in. 'What's this man doing in here?' I asked.


"'What man?' She said. 


"'The man in the wheelchair.' 


"'There's no man in here', she said


"'Well, I saw him,' I told her, but she paid me no mind. I swear there was a man in a wheelchair."


Maybe she had a premonition. The next time we came we commandeered a wheelchair in the lobby and rolled dad up to her room. The long halls were too much for him. Maybe she saw him coming in her room in a wheelchair before he actually did.


There was an oxygen tube plugged into her nose and IV's stuck in both arms. There was a control for the bed and a button at the end of a cord for calling the nurse. She was a tangle of tubes and cables. She had a TV remote on the bed, but she kept losing it in the web of blankets and hookups. She could lift her left arm, but not flex or open her hand. She couldn't move her left leg at all. 


I decided to go out to the nurse station and ask exactly what happened to her and what was being done for her. There was a young woman sitting behind the counter. (To be honest, they're all young women to me now. They could be sixty years old and I'd say the young woman at the counter.) She kind of ignored me until I said, "Excuse me". Then she looked up. 


I told her my mother was in Room 261 and I wondered if she could tell me exactly what happened to her.


Well, no, she couldn't. She wasn't a nurse, just some kind of clerk, I guess. I thanked her, because I'm polite that way. I saw another young woman come down the corridor who appeared to be a nurse. It is hard to tell who's who anymore. Nobody wears white, doctors or nurses. Maybe the cafeteria lady shows up in a white apron, but everyone else is wearing "scrubs", except the scrubs today look like the frocks Kindergarten teachers use to wear, gaily colored with joyful little images. My daughters wear the same kind of scrubs at the shelter where they work as VetTechs. But I was willing to bet the lady walking my way was probably not a VetTech.


"Excuse me," I proffered again, "can you tell me anything about my mother. She's in Room 261."


"She had a stroke," she said.


Yes, we knew that. "What is the extent?" I asked.


"Oh, you'll have to ask the Nurse-on-Duty for any more information."


"I though you were the nurse."


"No," she said and I said, "Thank you," and we went our ways.


When I finally caught up to the Nurse-on-Duty it was a different day and time, but same old conversation beginning with the same old, "Excuse Me".


"Can you tell me something about my mother? She's the lady in Room 261."


"She had a stroke."


"Okay, but is it going to improve? What is affected? How is it being treated?"


"I'm sorry," she said, "but you'll have to talk to the Doctor about those things."


"Where can I find the Doctor."


"He's not here today. This is his day in that other town. You could call his office." She told me the name of his professional association.


That afternoon when I got home I looked up the number for his professional association online. I called the number. A woman answered who was either having a bad day or just didn't want to be there answering calls from pests like your's truly.


"'Lo. Such and such Associates," she said in a flat, boring, annoyed voice.


I gave my name and my mother's name. I asked to speak to Dr. Whatzit's. I told her my mother was in Room 261...


"Which hospital," she spat at me like I was the dumbest jerk who ever came down the pike.


I told her.


"That's the other one," she said. "Let me transfer you," and zap I was waiting out a ringing phone.


The next voice was at least pleasant. 


"I am trying to reach Dr. Whatzit," I say.


"Oh, he's at that other hospital today," she says. I'll transfer you..."


"No, I was just transferred here by them. Can you just ask Dr. Whatzit to call me?'


She took down the pertinent information and said she would get the message to him.


I waited for the phone to ring the rest of the day.


It didn't.


I was beginning to learn how things were going to go in the days ahead. I would quickly learn I might not be in Kansas anymore, but there wasn't any Wizard either. There wasn't even a curtain.

In a Beat of the Heart

My mother was a small woman in her youth, five foot two, eyes of blue, weighing 98 pounds with wavy auburn red hair. She was a country girl with dreams of being a movie star. She married at 20, had me at 21, and never fulfilled that dream.

The closest she got to the silver screen was a seat in a movie theater.

She could draw, especially birds. But that was another talent left behind by the demands of living.

I guess we all learn sooner or later that life isn't a rose garden.

Mom proved tougher than she looked, strong willed and strong bodied. You have to be to survive to 92, which she will reach this month. It appeared a few short weeks ago she would reach that milestone birthday standing, but that will not happen.

The prank happened on April Fool's Day. She woke and attempted to rise from bed. She felt dizzy and then life changed for her, probably forever. She had a stroke.

It came like a beat of her heart, a flicker of an eyelid, a flick of your Bik, the breakdown of a small artery in the Pons area of the brain stem. Perhaps she was lucky -- perhaps. This is a risky area to have an episode. That part of the brain controls all the central nervous system activities, breathing, blood pressure and every motor control of the body. There is a condition known as Locked-In that can result from a brain stem stroke, a condition where the only thing the victim can move is the eyes.

This little tiny artery's failure took away her left leg, left arm and ability to swallow (this being something we will come to question later). She was rushed to a hospital ten miles away and I wasn't informed until the fourth day after.

Dad gave me the hospital phone number and her room, 412 he said. I called the hospital, but it was not there. So I clicked into the Internet and searched it out and sure enough, Dad had given me the wrong number. I now called the hospital and connected and asked for 412. A stranger's voice answered and they did not have my mother there. I apologized, hung up and called the hospital again, this time asking for her by name. Ah, she was in 410, my dad had the room wrong. She answered the phone and although slightly slurred and weary could speak. I told her we were coming.

And so we went, my wife and I, through the heavy traffic that the road construction made seem even heavier to my dad's home, the place I spent my teenage years. From there we drove to the hospital. I left my wife and dad at the entrance, he leaning on his walker, while I drove what seemed like into the next township for a parking spot.

Once I rejoined my crew we went to the elevator and I pushed the fourth floor.

"No, no," growled my dad, "she's on the sixth floor"

"She's in 410," I said.

"She's in 610," he insisted.

Nonetheless, we exited on the fourth floor and started the trek to room 410, my dad protesting that she was in 610 all the way, until his breath was too depleted by the walk to say anything. 410 was nearly to the end of the long hall we entered at the end of the first long hall we had traveled. I walked into this room and it was empty.

I came out and went to the nurses' station, which was as empty as the room. In a moment a nurse came from a side door, glanced briefly my way then sat down and made a phone call, apparently a personal one. I stood waiting. Another person appeared, but briefly, and flitted away back through that same side door. Finally I caught the phone-caller's attention and asked about my mom.

"They moved her," she said. "She is in 261."

Back down the long halls to the elevators we went, slowly because of my dad prodding along on his walker, still insisting we go to the sixth floor.

We reached the second floor and guess what? Room 261 was the furtherest away room upon that floor, I think it had a different zip code. My father was exhausted. We had to commandeer a seat from some office for him to sit a bit before we ventured on to find my mother.

When we walked into Room 261 she looked like a little lump in the middle of many tubes and cords. She looked frightfully close to how a person appears when they slip over into death, but she opened her eyes and was alive.

None of us yet knew what lay ahead.