LIV. Eleventh Hour Bleed Out

Thursday, February 9, 2012 — The phantom of my blog came up behind me early this morning and tapped me on the shoulder. “We’ve got a bleed out going on over there,” he reported.

“I know,” I replied. “It’s been going on for more than a week, all I have are Band-Aids, and they are ineffective.”

Geri, my Hospice social worker/bereavement counselor called me at 8:30 yesterday morning to give me a heads up, in case I got no other call, that our Hospice aide would not be able to make it. She was due at 11:30. I called the aide scheduler. There was no one to replace her. “What shall I do, then?” I asked the scheduler. “I can’t just leave her lying there without being changed and fed.”

“I don’t know,” she said with finality.

“What about Friday and Monday?” I asked. “We’ve known for well over a week that she will be off those two days. I have discussed this with the team manager.”

“I will find someone today,” she said. “I will be working on that this afternoon.” No one called.

Yesterday morning I called Daphne, our state Attendant Services healthcare aide, who comes in the evenings. I had to wait to make the call until she was done working as a crossing guard at the elementary school. Knowing that she does not have to work for us in the mornings, she often makes other appointments – you know, to take care of her actual life. Fortunately, she had made none for Wednesday and was able to come change, bathe and feed Emma. I cannot lift and turn Emma in her bed; I have neither the strength nor the height to give me leverage.

Prodded by the persistent haunting of my phantom, and having meetings and other things to attend to this afternoon, I sprang out of bed early this morning (at my non-morning person best) and called Hospice. Knowing our team had team meeting all morning as soon as they had time to get their coffee and settle into their bunny slippers or whatever, I called at 8:30:

Me: Is our aide coming this morning? She called out yesterday.

Aide Scheduler: Yes, she will be there as scheduled.

Me: And have you found an aide for Friday and Monday?

A.S.: No. I will be working on that this afternoon.

Me: You told me yesterday that you would be working on it yesterday afternoon.

A.S.: Well, I didn’t get to it.

Me: I need to know, because I have plans Friday, a driver coming to take me to the store and to pick up my new eyeglasses so I don’t have to wait another week, when the driver comes again, to pick them up.

A.S. I assure you we will find somebody.

Me: I’ve heard that before and nobody shows up.

We hang up. I consider the situation. The phantom proceeds to light little fires to place beneath certain posteriors. I call back and ask to speak to the team manager, with whom I spoke a week ago about finding a replacement aide for Friday and Monday.

Team Manager (her voice sliding down the tonal scale): Well, now, Samantha, just relax. It’s only eight-thirty in the morning.

e: Yes, eight-thirty in the morning a week after I discussed finding a replacement with you the first time, and nothing has been done.

T.M.: I heard what the aide scheduler said to you, that she has somebody but she doesn’t have a name yet.

Me: I don’t care about a name; I just need to know she has somebody definitely for eleven-thirty tomorrow and Monday.

I hang up, turn, and there in front of me stands the Head Gargoyle of My Subconscious.

H.G.: You don’t deserve that tone.

Some people find me hard to take. I am not hard to take; I am simply outdated. If I had done my job the way the generations of today do, my employers would have found me hard to take and gotten rid of me. Those of the Outdated Generation will recall Sergeant Joe Friday: “Just the facts, ma’am.” Whatever happened to that?

I call Hospice again and speak with our chaplain, to catch her before they go into their team meeting so that she can advocate for me and tell them the real facts of the situation. I am at the point of tears.

She says she will and tells me the team manager has my best interests at heart.

I call the ophthalmologist’s office and leave a message to find out if my glasses will be ready for pickup tomorrow.

A girl from the Brittany-Tiffany-Amanda generation calls me back. I answer the phone just as my machine picks up the call. “Hello, hello,” I say. I stop the machine. She starts talking, and talking, and talking, then says thank you and is about to hang up. “Whoa! Wait a minute! Whoa!” I exclaim.

“You don’t have to shout,” she says.

“Well, you won’t stop talking and I’m trying to make you hear me.”

“If you weren’t talking on your answering machine and talked on your phone …,” she starts—

“I’m not that stupid,” I say. “I am talking on my phone.”

Still she doesn’t listen. Finally I make it clear to her that I need to know before tomorrow if my glasses have come in, so that I can pick them up. She calls back later and in her best high-pitched Tiffany voice informs me that they have just come in, and “Thank you,” she sings.

The delivery company phones to ask me what time today I want Emma’s gel mattress to be delivered. With the increased dosage of Haldol, Emma moves very little in her bed, so she has the beginnings of sores on her lower back and heels. We put pillows under those areas, but she manages to wriggle off.

I tell the delivery company morning will be best because then in the afternoon I will have help here to place the mattress beneath Emma and on top of her thin hospital bed mattress. The woman who calls says OK. Soon after, she calls me back. “He has a lot of deliveries this morning and can’t make it until later in the afternoon,” she says.

OK, whatever.

When the Hospice aide comes this morning, she says that she was out sick yesterday, having caught some kind of a bug at a healthcare facility. She tells me none of her patients knew she wasn’t coming yesterday. They said, “Where were you yesterday? No one called. No one came.”

Later, the team manager calls to tell me that I will have a CNA, and her name, Friday and Monday. I thank her.

Geri and Tess, our Hospice nurse, come in the afternoon. They tell me that because of the continual changes in their patients’ statuses that healthcare aide visits cannot be scheduled too far in advance. OK, that makes sense. Finally, the facts. Geri is excellent at conveying to me the straightforward facts. Instead of keeping me in the dark, all the scheduler would have had to say was, “I can’t get someone for you this far [a week, two weeks] in advance, because we won’t know how our patients’ conditions will evolve.” Simple. That would free me to make my plans. It would also save a lot of kindling and firewood and thus freeing the phantom of my blog to go about his normal activities.

Tess re-dresses Emma’s wound, which people whisperer Nurse Mirabel had come and dressed last evening, placing on it a more permanent, cushioned dressing to prevent further trauma and help the wound heal. Tess brought padded heel protectors and affixed them, as well. They are like open-topped and open-toed blue and pink plaid shoes with a Velcro strap fastener. Fancy.

The gel mattress was delivered midday. It is rolled up. It weighs a ton. I cannot lift it. The Certified Nursing Assistants (CNAs), Tess tells me, are trained in how to place the mattress on the bed with the patient in the bed. Tomorrow morning Daphne will overlap with the Hospice CNA to give me time to grocery shop and pick up my glasses. Hopefully they will successfully place the gel mattress on Emma’s bed while I am out.

Tess told me that Dr. Patel wants me to decrease Emma’s Haldol to half the dose mornings and evenings, now that her agitation is stabilized. I thought he might. Should she become agitated, he says I am to give her one milligram per hour, as needed.

February 10, 2012 — My driver, Linda, took me to pick up my glasses from Brittany-Tiffany-Amanda, who had me sit at the optician desk in the middle of the ophthalmologist waiting room. She will fit the glasses. The glasses have graduated lenses, for near, arm’s length, and distance. I tell her that when I hold out the paper in my hand a certain distance the print is not clear. “That’s not arms length,” she says in her high-pitched singsong. And we are off: “Am I speaking English?” I ask. “Do you speak English? Do you comprehend English?” She assures me I am and that she does.

“I cannot have a conversation with you, a reasonable dialogue,” I say in frustration.

She whines, “I am not going to let you put me through what you put me through yesterday.”

Then, like an automaton, wordlessly, she pulls out a box (I’m hoping it’s not Pandora’s) from under the desk, opens it and lays out an array of glasses cases, as if spreading before me a royal flush. I am about to create a scene. The waiting room is full of people – parents, kids (I am trying to figure out what holiday this is, that the kids have off from school yet again), grandparents – I shoot up from my seat and fly over to the counter. “Whom do I complain to?!” I demand.

“Oh, I don’t know,” the girl sitting behind the desk says without looking up from her computer screen. “No one.”

“No one?”

“No one.”

Where are my friends R and Jean to fashion language for me when I need them?

When I return to my seat Brittany-Tiffany-Amanda has enveloped my new eyeglasses in a hot rose-pink case. “Why did you do that?” I ask. “I did it because the color matches your [wire] frames,” she says. The whole time I am sitting at her desk, scenes from a Seinfeld episode flash into my mind; I can’t pinpoint which one. (If you recall, please tell me.)  I tell her to get out all the cases again whereupon I choose a ’40s retro floral pattern, grab Linda from the chair where she is reading, and exit posthaste.

Linda takes me grocery shopping to our wonderful Willey Farms where I pick up some locally grown collard greens and French-style macaroni and cheese made with butter and cream that Thomas Jefferson would exude pride in bringing home from Paris, and then to the supermarket. I get home, a yellow tabby tomcat is sleeping in the tulips and daffodils in my flower bed, and Emma is sleeping peacefully on the new gel mattress Daphne and the substitute Hospice aide have efficiently settled onto the hospital bed.

A friend sent me a message stating that her roller coaster is beginning again. I reply that it’s a wonder I haven’t been blown off the top of mine by now.

Samantha Mozart

I wish to acknowledge that my ideas to use “bunny slippers” and the “Brittany-Tiffany” generation names are lifted from those my sister Kathleen Long used in two of her novels. This is a nudge in her direction.