Wednesday, July 25, 2012

Change of scenery...

I’m in a pretty good mood in spite of all the frustration and drama of the past few weeks. I’m focused on moving forward and doing what must be done. I’ve accepted what’s coming and that has provided me with some sense of relief. I thought about writing about yesterday’s frustrations and the unprofessionalism of people who, in my opinion, should have the upmost in professionality. But my mind is going in a different direction and sometimes --- well --- you just have to let it wander.

Although I’ll soon be living just blocks from the Atlantic Ocean, I’m really not much of a beach person. I love the mountains with all the tall trees and clean air. I love the sounds of solitude and the sight of the sun setting behind the treetops. That’s where I am most able to recharge, regroup, and redefine my whole being. Autumn in the mountains is my favorite time of year. Sipping on hot coffee on a frosty morning and sitting by the fireplace in the evenings while reading a good – that’s my idea of heaven.
Years before moving to the Carolinas, while we were still in California, I found an ad for some land in the Klamath Mountains in Oregon. On a whim, Alea and I decided to take a road trip and check out the parcels that were available. It wasn’t so much that I wanted to buy, but rather, I just wanted to look. Road trips with Alea are always fun and I love our bonding time together.

As we made our way up Interstate 5 we passed through the town of Weed and saw an old-fashioned motor lodge where each room was an individual cottage with a carport type garage attached. We could image a Model T Ford in the carport and the travelers settling down for a night of rest. Back in the day it would be a very long drive between rest areas.
Once passed Weed, we diverted our to route to Highway 97. It can be quite boring. No tourist towns. No Stulkey’s fudge ads. Just small town communities in between lots of farm land. Utility poles lined one side of the road for a while and then switched over to the other side after many miles. There were farm houses off in the distance. At one point trees seem almost non-existent – except for some that were part of the yards of the farmhouses.

We had each been quiet for a time with each of us in our own thoughts. Then Alea asked “Do you think the number of trees in the yards is an indicator of how wealthy or the class level of the owners?” I turned my head and stared at her. I wasn’t sure if she was kidding or if she meant it to be a serious question. There was no hint of amusement in her face. I couldn’t help it. I wanted to answer her seriously but instead I burst out in laughter leading to tears streaming down my face. What on earth was she thinking??? So I said (or I tried to say thru my giggling) “Maybe when the income taxes returns are filed, their income is evaluated and then IRS gives them a tree if they made more than last year.”  Both of us were laughing uncontrollably by this time. “OH!! LOOK!! They must be having very good years!!”
Now that we were started on poking fun at our surrounding and finding humor from simple things we were on a roll. We saw signs along the highway that informed us we were in a “Deer Crossing” zone. We wondered if the deer knew they were to cross there at that very location rather than crossing farther down where there was no crossing zone sign. We came up with many different scenarios of how the deer could be informed of their crossing restrictions and what the punishment would be if they didn’t abide by those rules. It was as ridiculous as some Dr. Seuss books. We didn’t care we were thoroughly enjoying our absurdness.
In some places the utility poles seemed to be shorter than others. There would be miles of short poles and then miles of taller poles. We couldn’t figure out why that would be. We tried to come up with all the rational practical reasons, but none of them were working for us. We surmised that the work crew for the shorter poles must have had shorter construction workers and that the poles seemed high enough to them. The taller poles were constructed on days when the crew contained taller workers. It made sense to us at the time.
By the time we reached Klamath Falls, we were exhausted from the long trip and our sides ached from all the laughing. We found a room and slept in the next morning. Then it was off to view all the parcels of land that we had researched previously. It was so reasonably priced that it was almost scary. But people had already been buying up the land and were actually settling into their surroundings. Maybe it was not such a far-fetched idea of latching onto a piece of land for ourselves.
On Sunday we spent the day checking out the town and exploring the area. It was a layed-back kinda place with lots of little interesting gift shops. I could almost see myself living here. Of course, there was not much work here for an executive assistant or real estate title examiner. I would have to take a substantial cut in pay and I doubted that would be something I was interested in doing. I had never really intended for this to lead to the possibly of me leaving my current job and moving to Oregon. This was just a fact finding mission mixed with a mini-vacation from home.
The drive home was filled with talk of family matters and things of a more practical nature. We agreed Klamath Falls was a nice place to visit, but probably not a place to live. However, buying a parcel of land and using it as a “vacation” retreat was not a bad idea. If only there was a more accessible route rather than Highway 97.
Pulling into my driveway, I felt tired but refreshed. I returned to the reality of the here and now. I checked in on my brother (who was dying from leukemia) and thanked the family friend for taking time from her job to stay with him while I was gone. The respite had been good. It was what I had needed.
Maybe as I begin a new phase as caretaker for Riley, there will be a mini-vacation respite with one of the kids that will give me memories as wonderful as the ones I gained from Klamath Falls.

Sunday, July 22, 2012

Get your copy now!

The
Immortal Alcoholic's Wife
is now available!!

See the right side bar for the "Buy Now" button and download your PDF version of the book. Kindle and Amazon will not be available for several months. Get it now and download it too any app that accepts PDF documents!

Old fashioned marriage...

I’m old school. I freely and openly admit that I was raised in an era when things are now looked upon as “out of date.” I’m not alone. I’m a baby-boomer and, last I heard, we make up the majority of the senior citizen pool. I’m just freakin’ fine with that. I’m proud to be from the time warp where family was everything and a person’s handshake was as good a signature. I drank from the water hose and rode my bike without a helmet. Those were the days my friend.


Riley is nine years older than me. But, I know his childhood was, generally, much the same as mine when it came to how things were back in the day. We were raised with a certain mind-set, a certain set of beliefs and the knowledge that if we worked hard and paid our dues – in the long run – we would reap the reward of the golden years. We didn’t know that the “Golden Years” are not for sissy’s.
Both, Riley and I, were sixteen years old when we got our first bonafide job. We started paying income taxes and into our Social Security plan and we were proud to do it. We believed this was in our best interest as well as our country’s. Riley is now 73 and I’m 64. We’ve been paying into Social Security for the better part of 50 years. If we added up all the money we have paid into the program, I would imagine it would be a sizable amount even though we were always a middle-income couple.
When I found out that Medicare – part of our Social Security program – wasn’t going to pay for Riley’s nursing home, I was a bit taken aback. How could we be paying into something for so long not help us at a time when it was most needed?
The truth is… I’m not alone in the belief that Medicare will take care of us. When I met with the social worked at the Veteran’s Administration, she explained that many people are under the false impression that Medicare will pick up the slack. Yes. Medicare will pick up certain expenses, but the reality is they will not pay for any type of custodial care. She explained further that when reality hits, it creates a form of culture shock. People in my age bracket have worked most of their lives and enjoyed the fruits of their labor – such as health insurance. When they retire, the company provided health insurance goes away or becomes too expensive to continue. They are left with Medicare which covers many things and is a Godsend when illness takes over. But, it leaves a lot uncovered and the quality of care often goes down considerably.
Riley and I have always been well-insured between his military medical and my private health insurance; we had our choice of the best doctors and hospitals. You would think when Medicare got added to the mix, we would be even better off. When I was forced into retirement, I could not pay for the private health insurance. Somehow I had the mindset that we would be OK because we had both military and Medicare. But it was simply just a false sense of security. When it was explained to me, I thought – OK that was a kick in the reality pants. What’s next?
I never in my life thought I would be applying for Medicaid. In the past we had enough money to take care of ourselves and I would never imagine that I’d be faced with asking my government for money to help support me. This feels like Welfare and I’m just not a Welfare person. BUT WAIT!!! As the social worker so aptly put it – have I not been paying taxes for about 50 years? Have I not paid into the system? The answer was YES – I (we) had been paying and paying into the system for the majority of our lives. It’s not “Welfare”. It’s a benefit from living in this country and paying my dues. I’m not asking the taxpayers to foot my bill – I am asking for the use of the money I have contributed. I know there was no “Medicaid” account deduction on my paycheck, but isn’t it implied? I had before never seen it from that point of view.
I really don’t want Medicaid to pay for Riley’s nursing home expenses. I’d rather get the assistance in the form of an allowance for a personal care attendant for Riley. That seems reasonable to me. It’s the only way I can save my sanity and still tend to Riley’s care.
As far as Medicaid taking all of Riley’s income to pay for a nursing home, that doesn’t seem unreasonable to a certain degree. If I could maintain a portion of his income and give the rest to the nursing home, I might be able to get my mind around it. But, that leads to a whole other issue that also seems to be “old school.”
Back in my day when a couple married – they truly married. Their lives became one just as their assets and debts were combined. Both paychecks went into one bank account and the bills were paid without regard as to which of the couple initiated the expense. The house payment was not divided into his and hers. The car payments were not split by the one who drove the car the most often. Everything was shared – money, cars, house, children, mothers, fathers… everything became the property of the couple who were now ONE entity.
I sometimes hear my niece say that her husband couldn’t pay his share of the house payment or his car payment this month and I wonder if they are married or just roommates. I know it is not this way with all young couples, but it seems to be getting to be the norm rather than the exception. That’s not how I have viewed my marriage with the exception of the time when we were separated. Then Riley was on his own and I supported myself.
When I took Riley back in there were expenses that needed to be met and his lack of responsibility for his credit cards needed to be reckoned with. Once again, we combined the money and I managed to dig him out of the hole he had created while still maintaining the obligations I had created before he came back. Besides that there were issues of the expense of taking care of him – personal aides, diapers, etc., etc. Using my employment income and his income, I managed to provide him with everything he needed – everything WE needed. And now, since I am retired, I have replaced the employment income with a social security check – a far less amount.
We have encumbered “joint” responsibilities – such as the lease on a house that accommodates our needs. I’m still paying on many of his prior obligations – such as a tax debt that I will be held responsible for as his legal spouse even after his death. Since his heart attack, any money we had put aside was used to meet transportation and other expenses while being at his side in the hospital which was more than two hours from home. He has had special needs with being in the nursing home as well. Why should I not use his (our) income to help pay for these encumbrances? Should I just ignore the bills and say “Oh well…”?
A divorce will not solve my financial problems. Any encumbrances made while legally married will still be my responsibility even after divorce. Also, if I divorce now, I will lose the only health insurance I have – my TriCare through the military. We need to stay married for another year for me to be “grandfathered” into TriCare. And I won’t be eligible for Medicare for another year. I will also lose the ability to receive the Veteran’s Admin allowance called “Dependent’s Indemnity Compensation.”  Divorce is not a good option for me.
My daughter reassures me that she will not take her father into her home. She says she is past it. But, I don’t trust that she will be able to stand by that decision as she watches him slip further downhill. I don’t trust that she has that resolve. My grandson, has shown incredible grief as he sat by Riley’s bed waiting for him to die. I didn’t expect that. I still must be the barrier between Riley, Alea and Ryan.
One of my readers believes I’m just after Riley’s “pension” money. Well… I guess she’s right. I DO want to be able to keep using the money in his retirement check. We are a legally married couple who have made financial commitments that are binding to us as a unit of one. I’m not willing (nor able) to go back to work full-time in order to meet obligations that are the responsibility of both of us. It might kill me to have Riley come back home and have to manage his care, but it will definitely kill me if I try to go back to being an employee in the working world. I’ll leave that job for someone who needs it more than I – like parents trying to raise their youngsters.
When I thought Riley wasn’t coming home, I started to prepare for a big loss of income. Moving with the grandkids and settling into a much smaller place was part of the plan. But, I was also looking forward to a future that included new adventures – like taking the OARS Group to the next level of public meetings. It will still happen – all of it will happen – it’s just that my timeline will be extended.
 Am I still in prison? Yes. But, it’s up to me to make those bars more elastic that they have been. I may not be able to escape permanently for a while – but I’ll still venture out when I can.

Saturday, July 21, 2012

Outwit, outlast, survive...

I should have expected that something weird would happen on Friday the 13th. But, I’ve always ignored the connotations of bad luck and simply gone on about my business. I didn’t see why this Friday the 13th would be any different. In fact, I had planned the first ever public OARS meeting for that day. I figured that it might be a bad day for caretakers of end-stage alcoholics and that they might need some extra support. I was not prepared for how my day would go from a personal point of view.

The day before 13th, I had received a phone call from the hospice nurse informing me that Riley was going to be removed from the hospice program because he appeared, physically, to be improving. In order for him to stay in the program, there had to be a decline in his condition. There was none. However, hospice does not do lab tests. So they really could not determine that Riley was dying from end-stage liver disease. All they knew was that he was not as yellow, eating well, and generally had a good attitude.
I asked what that meant to me. What would happen next? I was informed that Riley would stay in the nursing home. Nothing really would change except he would no longer be under VA’s hospice care program. OK. That was acceptable to me. I didn’t see a problem.
On Friday the 13th I received a call from the business office of the nursing home. A very pleasant young lady wanted to know how they should proceed with the billing of Riley’s account since VA would no longer be paying for him being a patient. The daily cost will be $250/day which comes to more than $7,000 per month. I was a little taken back, because I thought VA or Medicare would be paying for his continued stay. No. VA doesn’t pay for any custodial care. Neither does Medicare nor TriCare. The only way to keep Riley in the nursing home was for him to be admitted to the hospital for three days. Upon his hospital discharge he could go directly back to the nursing home. The only problem is that there is no viable reason for Riley to be admitted to the hospital.
I explained that I am not physically capable to taking care of him. What would happen if I just didn’t come get him? The answer was that they would keep him, but they would start billing me for the $7K each month plus incidentals.
There had to be some other options. People have elderly family members put into nursing homes all the time. How did they do it?
I was advised to apply to Medicaid to try to get some assistance. But, I’m sure I make too much money for that type of aid. Then I was told that if I used the Medicaid option, all of Riley’s income would go toward the nursing home. I would be left with only income that I had separate from Riley. Well… since I’ve retired, that would leave me with only my Social Security. While I know that people live on less, I didn’t see how I would be able to pay my $1100 rent and my utilities with my $1200 per month. This did not seem like a viable option.
My next step, in the panic of realizing that Riley may in fact be coming home, was to start making phone calls. I tried everywhere in the Veterans Administration but it was Friday and all my calls were going to voicemail. I tried Medicare. I got a real person but the info provided was what I already knew. I called Medicaid and again there was no new discovery there. This Friday the 13th was not turning out very well for me.
Images of me trying to get Riley into the van, out of the van, up the steps and into the house was more like a slap-stick comedy. Then there was the issue of not having a bed for him since I had gotten rid of the feces and urine saturated bedding long ago. How would I tend to his personal needs and still keep myself safe? I wasn’t sure and no one had any answers.
Late in the afternoon the hospice nurse called to tell me that they had decided not to discharge Riley until Friday of the following week. I breathed a huge sigh of relief. I had a week reprieve. Maybe I could get some help from someone.
I walked around the country house and saw all the boxes I had packed in anticipation of moving closer to the kids. I beat myself up over not listening to my gut instincts. I knew deep down that Riley is immortal. I didn’t truly believe that he was never coming home no matter how many times I had been told those words over and over again. Even when I gave my landlady notice, I had a little twinge in my stomach that something was just not right. I went ahead and made plans and proceeded to act on them.  I convinced myself that I could trust the medical community and move forward in my life. After all, more than five med pros had told me that Riley would be in a nursing home for the rest of his life.
The following Monday I was back on the phone again. I talked to the head of the VA hospice program for our area and even she was confused as to what had happened. She requested his records so she could review the decision. In the meantime, she told me to prepare for his homecoming but that she would not allow him to be discharged until the last day of July. I told her that if he comes home there is a good chance that I will die before him. I asked her what would happen to him then? She had no answer. I mumbled something about how irritating it was that my life is expendable in order to save his – a life that he clearly did not want.

I’ve called the Senator’s office again and they are trying to rush through Riley’s disability application in order for me to have the funds I need to hire a personal care aide. The VA has provided me with a hospital bed and wheel chair. I just found out I can also get other items I will need, like ramps into the house and van.
Today I will send an e-mail to my landlady and ask if I can stay another 30 days at this house. My plan was to stay with the kids for a while, but there isn’t enough room for both me and Riley. And I don’t want Riley around the small children. If my landlady does not agree – I don’t know where we will be living. If I can stay, I’ll have 30 days to find a place suitable for the two of us in the same town as the kids. It will have to be a cheap place because the cost of an aide will quickly empty what is left of our shrinking bank account.
As with every difficulty in my life, I always find a way to accomplish what needs to be done. Sometimes the way isn’t pleasant or what I want – but I survive. I know that the odds are against me right now. I know my health is not where it should be to take on the task of caretaking Riley. I know I’m in danger. Knowing all that means I must do everything I can to make sure that Riley does not outlast me. I am digging through all the packed boxes and looking for my “survivor hat.” I know it is in here somewhere…

Tuesday, July 10, 2012

Save the children...

I didn’t grow up in an alcoholic home. I had a cousin who died of alcoholism, but as a child I never experience any effects of his alcoholic behavior. I also had an uncle who always drank too much at Christmas and was very funny. I only saw him a couple of times a year, so if he drank more often than Christmas, I had no knowledge of it.

My father served in the Army Air Corp during World War II and was a radioman for bombers. His best friend was a gunman and sat in a glass dome on the airplane. After many missions the plane was shot down, but the first hit was the glass dome. My father tried frantically to get to his friend, but could not reach him. The friend was sucked out of the dome and his body was never found. My father never flew another mission. He went on leave and before he could get back into a plane, the war was over.
My mother told me once that my father had a lot of drunken days when he was first discharged from the Army. The drinking lasted for about a year after they were married. Then, according to my mother, one day my father just decided to let go of the pain and guilt he felt about his friend’s death and quit over-indulging in alcohol. She didn’t know what the catalyst was but she was grateful to whoever or whatever it was that made him “see the light” as she put it.
All that happened way before they had children. It wasn’t for another two years before my older brother was born. So we never witnessed my father in a drunken stupor. Was my father an alcoholic? I don’t think so. He did drink a time or two during my childhood – a highball at Christmas, champagne at weddings, a hot toddy when he had a cold – that was about it. A bottle of whiskey could sit in our cupboards for several years and not go dry.
What if things had not turned out that way? What if my father continued along a path of self-destruction? Would I be the same person I am today? Would any of my four brothers be the people they grew up to be? I think not. I think we might not have grown into the strong determined people we are today. We’ve all had issues. We’ve all been rebellious. But in the end we are turned out to be responsible, caring adults with a strong sense of family and a healthy work-ethic. I think that maybe we might have lost the ability to be those things if my father had not stopped drinking.
Children who grow up in alcoholic families have a tough time in life. They have difficulties in school and lack language and reasoning skills. It is difficult for them to solve problems in work assignments and that falls over into social relationships. If they have a friend and the friendship hits a rough spot, it is often difficult for them to find a way of working it out. These children often have a low opinion of themselves because they cannot control everything that goes on in the home environment. Other children strive for perfection and receive high academic grades. They believe if they are perfect enough, then maybe the alcoholic will stop drinking.
In short, children have an over inflated idea of their responsibility for the alcoholic’s drinking. They do not understand that they did not cause it and they cannot control it. All this leaves them with an overwhelming sense of helplessness and hopelessness.
It is not surprising to me that children who grow up in alcoholic families have a tendency to become alcoholics themselves. It is unclear if the alcoholism is a result of nature or nurture. I don’t think there is enough conclusive evidence to make that determination. But I do know one thing for absolute certainty and that’s that there is no room for children in an alcohol infected home.
I have often thought that if my son had not been raised in the presence of alcoholism, he might not have ever started drinking alcoholicly. Maybe my son would still be alive if I had left Riley and removed both of my children from the influence of alcoholism. However, Riley wasn’t around very much because he was deployed with his Navy unit for more than 50% of their childhood. So was Brian the recipient of some biological gene that he inherited from his father? It is just not clear. There were other factors that played a part in his death that had nothing to do with alcohol. But the end result is the same – my son died from alcohol related causes.

On the other hand, my daughter Alea, has no penchant towards over-indulgence in any type of alcoholic beverage. I’m sure she has experienced being drunk and has had a hangover in her earlier, wilder years. But, she is not much of a drinker. So what does that mean? She is Riley’s step-daughter, so she did not inherit any of Riley’s genes. But her teen years were difficult and filled with inappropriate behavior causing me to anxiously await her turn home after every evening that she went out. She protected Riley fiercely – after all he had been her father since she was six months old. They had a special bond that got stronger as she got older.

I just can’t help thinking that if I had left Riley and stayed away from him while the children were still very young, they would have a different life now. Maybe Brian would be alive to enjoy his life and maybe Alea would not have struggled so hard during her teen years. I’ve always believed that it takes a village to raise a child. If I had taken my children back to my village of non-alcoholic residents – my family – and provided them better examples of how to live their lives, maybe things would have been different.

My children are incredible. They are strong, independent, loving and I’m so very proud of them, even though one is gone. But, if I had it to do over again, I would not have subjected them to life with an alcoholic. If I had understood then what I understand now – I would not have hesitated for a moment.

If you are struggling with a decision of whether to leave your alcoholic consider the cost of staying from your children’s point of view. If you have very young children, do some research and find out what they might have to endure while wrapped in that insanity. It is scary to think about. Put yourself in your children’s situation. How would you want your childhood to be?

Wednesday, July 4, 2012

I hereby declare...

Today is Independence Day. I’ve already celebrated our country’s most patriotic holiday with my family on the Outer Banks, but today I’m going to have another celebration. Today’s celebration is for my own independence.

As the wife and caretaker of an end-stage alcoholic, there is no independence. Everything is done based on the needs of the alcoholic or the needs of protecting the home and others from alcoholic behavior. No matter how detached you are, there is still this invisible chain between the caregiver and the alcoholic.
My independence has taken a long time to achieve. Even now, I still have that invisible chain attached. But the chain is lighter in weight and doesn’t chaff me where it is attached to my body.  I’m doing things I want to do based on my own schedule. With Riley in the nursing home, I am able to get a sense of freedom.  The lighter weight chain is the one that has me going to the nursing home and visiting Riley every second or third day. The chain is about monitoring his care, providing direction, and attending doctor appointments. Before the chain was just a burden, now it’s productive. I guess that is what makes it seem to weigh less.

One of my commenters suggested I had had a “change of attitude”. I’m not so sure that my attitude has changed at all. I still think Riley is immortal. I still will protect my daughter from taking him into her home. I still feel the demands of fighting perceptions and sharing my knowledge and experience. If anything has changed it is my ability to see the possibility of a more productive and pleasant future.
These past couples of weeks have been very productive and I’m excited to report that the first ever real-live, in-person OARS F&F Group will meet in the real office of my addiction counselor friend. In my small town there is only one Al-Anon meeting. I believe this addition of the OARS group will fit in nicely with its meeting time of 4 p.m. on a Friday. Drunken weekends start on Fridays; this may help the caretaker deal more sensibly with the insanity of alcoholic-ness. If this goes well, I will consider starting a group on the Outer Banks and the Tidewater area. If you in the area, please join us on the third floor of the Old Bank of America Building, Broad and Eden Streets, Edenton, NC.

I’m also pleased to announce that the Veterans Administration Caregiver Support Division of Hampton Roads and North Carolina, have asked me to help set up a veteran caregiver support group. They have volunteered to work with me in the OARS endeavor and in return I will help with establishing their support group. It is such an incredible honor to be asked to help them. We’ve already set up our first meeting time and place and I’m anxious to get started. If you’re in the Elizabeth City area and want to attend the caregiver’s meeting it is going to be held on Tuesday, July 17th at 10 a.m. in the Albemarle Veterans Primary Care Clinic, 1845 West City Drive, Elizabeth City, NC. Although this is sponsored and supported by the Veteran’s Administration, the meetings are open to all caretakers in the general public.
The Immortal Alcoholic’s Wife is finished and currently being read by my daughter and grandson. When they have finished reading, it will be offered on this blog. The one offered on the blog will be “bare bones” in a simple PDF version. A real e-book version will be out within the next couple of months. I know many of you have been chopping at the bit for this book and I just don’t want you to have to wait any longer.  My hope is that an agent might take an interest in representing me to a publisher.  

Riley’s health condition has improved, but the brain function needed to live on his own is just not there. He is unable to walk on his own and therefore unable to tend to his bathroom needs. We don’t know for a fact that he had another stroke, but his right side is only minimally functional. He has stopped pleading with me to take him home, but I am still trying to find a different facility for his long-term care.
As far as my health goes, I’m now able to get through the day without a nap. I still rest in the afternoon, but I seldom fall asleep. I have made an appointment with a primary care doctor who has an excellent reputation as a diagnostician. I won’t be starting my food program until I’ve managed to eat my way through everything in the freezer. Once it’s empty, I can move it to the Outer Banks and just buy the appropriate foods that I need each week. I’m still not getting enough exercise, but also will change when I make the move.

I have a lot to celebrate. Even though I’ll be cooking only for myself, I won’t let that stop me from having some of the traditional 4th of July favorites – my yummy potato salad, curry-ginger deviled eggs, grilled steak, and fresh fruit salad… This year I think I might have some sparkling cider to toast to my survival through insanity.

Thursday, June 21, 2012

Live cells v. dead cells...

Last week Riley had an appointment with a Veterans Administration doctor in order to set up a primary care relationship with the local VA clinic. I had originally thought it was an evaluation for his disability compensation claim, but I was wrong. This appointment was only to do with his request for VA medical services.

I’ve heard a lot of horror stories about these clinics and the medical staff. If this clinic is representative of other centers, those horror stories are without merit. I found the clinic to be very clean and well equipped. The staff was friendly and cooperative. Things felt as though they had all been trained in the art of efficiency and customer service. I was impressed.
I was also impressed with the demeanor of the doctor that had been assigned to us. He was knowledgeable and spoke to me as one human being to another. He didn’t use medical-eze which would leave me running to Wiki to find out what he had said. He was a real person who used his own personal experiences to show that he understood what we had been going through. He explained and when I left I felt we had a plan of action and I knew the consequences of all the possibilities.

While we were all talking and relating, he was examining Riley. It wasn’t a huge exam. There was no disrobing or standing and touching his toes, but rather simple things.  To a lay person it might seem that he did next to nothing of a real exam. That assumption would have been wrong.
This is what I learned –

The liver can, in fact, regenerate new cells and continue to function. However, there must be a sufficient amount of LIVE cells for regeneration. DEAD cells are just dead. They cannot regenerate. The just remain as scar tissue impeding proper function. If the liver has been constantly asked to recreate itself over and over again, it will get to a place where the regeneration cannot replace all the cells that have been killed by the intruding factor. New cells WILL regenerate, but the question is will it happen fast enough?

The only way to really determine how much of the liver is functioning is to do a biopsy. It’s a simple procedure of inserting a needle into the liver and withdrawing a sampling of the cells. Without the biopsy there is no way of telling the percentage of dead cells versus the live ones. However, the procedure generally causes heavy amounts of bleeding. Alcoholics are susceptible to having bleeding issues and are not good candidates for the biopsy. In Riley’s case the risk of him bleeding out is not worth taking the chance that a biopsy would present. So for Riley -- we don’t know and we won’t know how much of his liver has the capacity to regenerate.
The same theory works for LIVE cells and DEAD cells in the brain. However, the brain is not as forgiving as the liver. Alcohol anesthetizes many of the cells so that they do not function properly. Other brain cells are simply killed off. As the alcohol stops entering the brain, these anesthetized cells seem to wake up and start functioning again. But the dead ones are just gone forever.

It is obvious from observing Riley that he has made a remarkable improvement. However, he is now about a month from the heart attack and the condition he is in currently is about as good as he is going to get.  He will have very good days and very bad ones. But this is what it is and this is what it will be.
I’ve been trying to visit Riley at least every two days. Sometimes it’s longer. Visiting him less often allows me to see his progress more clearly. If I see him every day the subtle changes may not be as noticeable to me.  And I DO see changes. His eyes are much clearer and skin is not as yellow. He doesn’t mumble so much when he talks. He is able to follow a conversation – to a certain degree. He is also developing a desire to maintain his personal cleanliness and keep track of the schedule. He knows that does NOT want to be there. He wants to come home so that he can drink.

 S..i..g..h..

This puts me in a Catch-22 position. If he stays in the facility, he will not drink and live longer and healthier. If he comes home and can get alcohol, he will most likely die within a year but be happier about where he lives. I would like to say that this is about the “quality” of his life. But that is subjective. What would be a quality life for me would probably make him miserable.
There is the issue of having him come home endangering my health. Caretaking him has had a huge negative effect on me personally and medically. I have no desire to die. I asked Riley how he would feel if he came home and then woke up one day to find me dead on the kitchen floor. His response was that he would be worried about who would be taking care of him now. WOW!! There was no expression of regret or even that he would miss my company. His only concern was how my death would possibly upset his living arrangements.

The doctor at the clinic has noted in Riley’s file that he should be institutionalized because he is a danger to himself and others due to the fact that he will not stop drinking. Even if Riley is not displaying any outward signs of needing hospice, he is still terminally ill which will only be intensified by his return to drinking.
On my plate for today, I must request a comprehensive neurological psychiatric evaluation to determine if he is competent to make his own decisions. If he is deemed incompetent, he will not be able to make the choice of staying in a facility or coming home. If he is, in fact, competent he will be allowed to make his own bad choices. But… really… isn’t that what he’s been doing all along??

Saturday, June 16, 2012

Help me help Anonymous...

I would like to refer my readers to a post written on March 14, 2012 "Crying wolf..." Not only is this post appropriate for the current time, it also contains a comment from a person who needs a little help.

This person is addicted to alcohol and drugs and has managed to achieve some sobriety after a visit to rehab. Currently he/she has slipped and is struggling to get "back on track." I'm asking all of my readers who have been in this position to please offer some encouragement and support.

I'm not an alcoholic so I can't ever truly understand to my core how difficult it is to "get a gripe." I know my limitations. So I'm reaching out to all of you to help me help Anonymous find the way back to sanity.

Thank you very much --- Linda

To Anonymous (the last commenter on "Crying wolf...") --

I hope you are reading this and will know that the support here is heartfelt from people who could have written your story themselves. Please reach out and return to a life filled with possibilities.

Linda

Friday, June 15, 2012

No longer sequestered...

I just spent the past week in the Outer Banks of North Carolina. The time spend with my grandkids and great-grandkids is priceless.  However, this visit was a bit more stressful for me.

Whenever I visit, I always think to myself that I can maintain all my communication and contact with my readers and OARS members via the internet. My left-coast family and the Riley’s nursing home/staff always can reach me via my cell phone. I’m not cut off from the world. I’m still here.
The only problem with that scenario is that the kids’ internet access was not working. They usually have free public access as a benefit for living in a resort community. But, for some reason it was not working. I packed up the laptop and went to the local MacDonald’s where there was always free wi-fi. But I got zip. Nada. Nothing. I spied another person on their laptop and asked if they were able to connect with the web. She told me she hadn’t been able to connect no matter where she was on the OBX. Oh! Well… this was not good.

After a couple of days the frustration seemed to fade away and I was able to relax and not be glued to the computer. It was actually rather pleasant. I was worried that my readers might think I had abandoned them, but realized that this was just a way of having a forced vacation.
I played hide and seek and build forts out of sheets and dining chairs. I cooked dinners that contained all four food groups. My great granddaughter went out looking for houses. I watched a countless number of Storage Wars with my granddaughter-in-law. I focused only on those days and I didn’t seem to worry much about what was going to happen when I went home.

There was a down side to my visit. I had taken Jade with me because I had no one to check on her at home. I had no dog sitter. She loves an adventure, so she happily jumped into the van when I called her. She was even happier when I made a stop at the nursing home so she could visit with Riley. She climbed right into the bed with him and gave him doggie kisses all over him. Clearly, she had missed him and was happy to make the reconnection. So far so good…  I thought.
The kids live in a typical beach box with is just a bit larger than a three bedroom apartment sitting on top of pilings. There is a yard, but it is not fenced in. They have a dog of their own – a sweet grey dog about half of Jade’s size.  He’s a little boy named Bently who is really still a puppy, so he’s full of energy. Bently walks on a leash and also does his business on a designated area of the deck. He’s a good boy. But – he is not neutered yet and thinks Jade, who lost her puppy-making-equipment  several  years ago, should be his girlfriend. Never mind that Jade is twice his size and totally not interested – Bently loves her. Bently wants her. Jade tolerates him.

Jade was pretty good about using the deck, but she would often go to the door and ask to go out. She’s 65 pounds and is not well trained in leash etiquette. She pulls as I try to walk her and I’m not strong enough to keep her under control. As a result, her outdoor time was limited. Indoors, she would play with Bently until she would get tired of his unwanted advances and then snap at him. They would both settle down for naps when Jade made it clear she had had enough. Jade is very patient with the little ones and allowed them to pull on her ears and give her hugs.
I can image the frustration Jade felt from being cooped up in a relatively small space with no freedom to run the fields or chase after mice, rabbits or birds. I equate her frustration to being similar to what I feel when I’m cooped up in the house with Riley for weeks on end. I can also see how it would be similar to Riley now being in a small nursing home room rather than the big space he had in the country house.

Now I am faced with giving up this country home and moving to the OBX. I know it will be a move that will make me more accessible to the kids which is what I want. As much as I dislike living in the OBX, I know it will be good for me. However, this will be a challenge. Rentals are scare here at this time unless, of course, I want to pay $3K for a place right on the beach. I must provide a place for Jade to have some access to the outdoors. There must be room for Riley if he should be able to return home. And I prefer it to provide some privacy and not be on pilings. It’s a tall order for that area.
For me, this move will mean I’m no longer sequestered in a remote area. As much as I love it here, I love my family more. All of the space out here, creates a similar frustration as Jade being coped up inside my grandson’s house. The loneliness of the open space makes it feel confining.

If I could pick up this property with the horse paddocks and open fields and transport it to Kill Devil Hills, none of us would feel confined or restricted. It would be the perfect situation. Even Bently could come to visit and chase Jade all around the paddocks. He’d never catch her – but he’d certainly have fun trying.

Wednesday, June 6, 2012

Am I an alcoholic?

I received this e-mail yesterday and I thought I should respond openly so that others may have the benefit of my response. I want to emphasis here that I’m not a professional anything. I’m also not an alcoholic and so my viewpoint is from someone who has not had the painfully gripping experience of addiction. That is – except for my morning coffee.

Hi Linda –
 I've been reading your blog for probably a year or so now. I don't recall how I stumbled upon it exactly, but I immediately took an interest. I'm 24 years old and I'm working on figuring out the extent of my problem with alcohol. I identify with a lot of what you have written in your blog, enough so that it causes me to worry about what the future may have in store for me if I continue along my current path.

It's certainly been addressed to some extent in what I have read in your blog, but I'm curious about Riley's history with alcohol. I would like to know how he got to where he is now. I'm very curious how much drinking it takes to wreck the havoc upon one's body that it has in Riley's case. How long did he drink and how much? I realize this may be a somewhat nebulous question, but as I read your blog I always find myself wondering how much does it take for a person to end up like Riley has.
As well, if it's not too difficult or personal to discuss, I'm also curious about your son, and his drinking in contrast to Riley's and the fact that Riley has some how managed to survive despite all odds.

If this is something you would like to post on your site I have no problem with you sharing my email.
Thank you.

Steve
In one of the pages on my blog, I write about the different stages of alcoholism. For the most part, Riley’s drinking route follows that road map. In my opinion, Riley’s alcoholism kind of snuck up on him and once it was there it was a permanent resident. I don’t know if it is that way for most alcoholics, but no one ever says “I’m going to start drinking booze until I become so addicted that I cannot live without it.” No one has ever made a conscious decision to become an alcoholic.

Back in the Navy days of the late 70s and early 80s, alcohol was an accepted form of beverage at recreational activities. There were “beer ball games” and “initiations” and “balls” and “cook outs” – and getting drunk was a pretty accepted way of celebrating. In Riley’s case, when the recreational time was over, he had difficulty making the transition back to serious work mode. While others were able to put aside the beer and wine, Riley was hooked on the euphoric feeling of drunkenness. I don’t know of ANYONE in Riley’s group during the late 70s and early 80s who became alcoholics from all the carousing that was done during that time. There may have been – I just don’t know about it.
So, for Riley, I believe it all started honestly enough. I think he truly believed he was not an alcoholic, but thought he was able to maintain his askew mental state by drinking small amounts each day. The only problem was that as he continued to drink, he was unable to drink in large enough quantities to keep up the desired “high” that he no longer wanted – but, in fact, needed.

Brian, on the other hand, follows a different scenario. In his teenage years into his early twenties, he did all the experimentation that parents frown upon. Alcohol did not seem to be something he was most interested in – it was other drugs that called his name. But, fortunately, he out-grew that craziness and went on to a wonderful job travelling the world and enjoying his bachelor life. He became a rational, responsible young man.
Alcohol did not become a part of his life until he became involved with a woman who was an alcohol abuser. To make a very long story shorter – he ended up quitting his travelling job and trying to settle down with this woman to whom he lost his heart. His life was never the same after that. He joined her in drinking and was often as drunk as she was.  That relationship ended, but the drinking remained.

It was only three years later, that Brian’s new girlfriend tried to communicate to me that his drinking had become a problem. In my opinion, she didn’t try hard enough to make me understand what was happening. I heard bits and pieces of things – innuendos and comments – but nothing that would alarm me to take a more proactive stand.
Less than one year after that brief communication by his girlfriend, my son was dead. 

The bottom line to all this is that there is no true and correct answer to the question of how long it will take for the alcohol level to become so high as to cause death. The style and progress of the drinking doesn’t really matter. The end result is the same – death.
Steve – my suggestion to you is to honestly look at your drinking and why you are imbibing. If you’re trying to maintain a certain level of “float-y-ness” then you are certainly on your way to a life of craziness. The fact that it is disturbing to you is also a cause for concern. Ask yourself this – is drunkenness the goal of a social function or is the goal enjoyment of family and friends? Would you decline an invitation to an event that doesn’t include alcohol? Do you leave the non-alcoholic event just to find the nearest means of getting drunk? If you are drinking at lunch or going to happy hour every night – you have a problem.

No one can say for sure if someone else is an alcoholic. Only you can make the determination. But, before you decide you are NOT, maybe you should go to a few AA meetings and talk to the people there. OR just listen -- you don’t have to say anything. The meetings are free and they are taking place everywhere.
One more thing you can try – just stop drinking. After a few days you will either be anxious to find a drink or you will not really care one way or the other. But, this is a dangerous precedent because often alcoholics say “I’m not an alcoholic because I quit drinking for (X number) of days and I was fine.” But, if that alcoholic returned to drinking and increased the intake – well – Houston -- there is a problem.

There is an excellent book named “Almost Alcoholic” that may help you. I’m not sure if it’s even been released yet. It was sent to me for review. The authors are Robert Doyle, MD and Joseph Nowinski, PhD and the book is being published by Hazelden. It was supposed to be out in April 2012. I think it might answer a lot of questions for you.
In my opinion, if you have the slightest little inkling that you MIGHT have a problem with alcohol – then stop drinking. If you find out you can’t stop – seek help. Do it now. Don’t wait until you’re under hospice care in a nursing home and think that you spend each night in the back of a truck at a residential fire. Don’t wait until you have no idea where you are or where you live or the names of the people who visit you. Don’t wait until you end up like Riley.

Saturday, June 2, 2012

Life in Riley World...

The nursing home called me late Thursday evening. In fact, they called me twice. Riley had fallen out of bed two times and they needed to inform me of that right away. He was not physically hurt. It’s not clear if he simply rolled out of bed or if he tried to get out of bed. They no longer use bed rails in the home because patients try to climb over them and hurt themselves. So they have placed soft mats all around Riley’s bed in case he falls again.

If any of you get cards returned to sender, it is because the nursing home had a little “snafu” last week. There was a temp on the front desk and no one had informed her of Riley Riley being a patient. If your card was returned, I apologize. The situation has been resolved and if you want to try to send it again, the card WILL get to Riley.  He truly enjoys getting these cards and even asked me to read Syd’s card to him twice. Thanks Syd!
So… when I visited Riley on Friday morning, I asked him how he was feeling after his fall out of bed. He responded with laughingly telling me he had been forced out of bed by the baby which hasn’t been born yet. I asked him if he was the baby’s father. He said that Tom was the father. He proceeded to tell me that he spent most of the night in a truck with two other guys. The two guys were able to get out of the truck, but that he had to stay inside because they were on private property and it would have been illegal for him to step foot on the soil. He said he sat there for more than three hours.

He was in a talkative mood. Riley told me that there had been a lot of sirens last night. He knew there was something going on because the green fire trucks were out. He said they were a puke-colored green and this was the only town he knows of that has them.  They have yellow lights instead of red. I asked where these fire trucks were from and he said “right here”. I asked where we were and he said Clinton, IA. Well… he’s only about 1,500 miles from his actual location.
I wanted to see how much he was really mentally here. I asked him who I was. He said I was his wife. I asked him what my name was. He hesitated and then said “Linda?” I talked to him about Jade and Jax, but he had no response to that subject. I don’t think he knew who they were. I told him I was going to move in with the kids for a while. He said OK but he didn’t want to stay in the country without me. So it seemed he was able to connect a few things accurately. He also told me that Janet (he meant Debbie), the nurse, told him that he may have to go to an assisted living facility. I asked how he felt about that and he said he didn’t know.

I promised his brother that we could try a phone call. I dialed the number and put it up to Riley’s ear. I don’t know how disjointed the conversation was because I couldn’t hear his brother’s end. But, when he hung up Riley explained to me that his brother had been snowed into his house for the past few days because the storm hit him hard. His brother didn’t know how long it would be until the snow plows would be able to get him out. That was interesting because his brother lives in the San Francisco Bay Area and there has never been enough snow on the ground to create any sort of hazard let alone enough to “snow him in”.
At the end of our visit, as I was driving off to run some errands, it occurred to me that Riley was getting better as far as his body was concerned. But, his brain function is way off. It was entertaining to talk to him. He didn’t take any sips from his imaginary glass. He didn’t ask me when he was going to come home. Mostly he was just in his own world and he seems to be enjoying it there. For some reason, it makes me feel better about the entire situation. Maybe that’s because he actually appears to be happy in Riley World.

Wednesday, May 30, 2012

Is he really immortal?...

I’m going to see Riley today. I’m wondering what I will find and if he will know that I really am there. Each time I visit him, he appears to be just a little tiny bit better than he was the last time I saw him. There have been no leaps of improvement. But still…

The liver is a miraculous organ. It can regenerate new cells to replace the bad ones. I’ve seen this happen with Riley several times. I don’t know when the liver degenerates to the point of not being able to regenerate enough cells to return to proper functioning.  I’ve talked to the hospice nurse and she told me that Riley has caused too much damage for his liver to be able to regenerate enough to be fully functional. The same thing goes for his brain.
This hospice nurse was assigned to Riley because she has experience with alcoholic deaths. While talking to her, I knew she understood concern. She carefully explained to me that it may take Riley a considerable amount of time to reach his end. Or he could have another heart attack and have it all end quickly. It really doesn’t matter because his brain function is so limited that he will never be able to return home. Fortunately, he is well-insured and is able to stay in the nursing home for as long as he is alive. He may be able to improve enough to go to an assisted living facility, but that would be a big stretch. She assured me it was time for me to move forward.
I suppose I’m a little gun-shy when I’m told that Riley is dying. He’s been dying before and has always managed to come back. I find it difficult to truly believe that he is not going to make it through this. I want to trust what I’m being told. I want to make plans for my future without Riley. But, I don’t call him the Immortal Alcoholic without reason. So… I guess… I must wait.
My fear is not that he will survive, but rather he will survive to a point where he might get discharged and sent home. He will never be able to live on his own again. I accept that fact. There is no place for him to go except to my house. I’m not physically or emotionally able to take care of him any longer – at least not with his inability to tend to his biological functions or inability to mobilize.

The best case scenario for both me and Riley is that he recovers to the point of being able to be placed in an assisted living facility or long term care. I have no reason to believe that cannot happen based on my previous experiences with Riley and death. The only thing preventing that is if Riley is capable of refusing that placement. I will have to firmly stand by my decision to not have him come home and not be his caretaker.  
Riley might not agree with me. He has stated a million times that he would prefer to be dead than to be sober. Who knows for sure? He always made those statements when he was in the middle of drinking. So now that he is in the condition that he is, how do I really know what it is he would want?
He wants to come home. Every time I visit he tells me that. He wants to sit in his rocking chair and talk on the phone. He tells me to make sure I turn off the TV in the den because no one is watching it. He tells me he wants to go to the living room and doesn’t understand why I can’t just push the bed in there. He wants his computer. In the few words I can really understand, I am able to understand all that. In between sips of his imaginary drink, he is clear that he wants to come home.
I feel that I cannot just sit and wait for Riley’s outcome. I’m taking the nurse’s advice and moving forward. I have given a 60-day notice on my country house and will move in with my grandson’s family for the summer.  I’ve already started on getting my health back by getting plenty of rest and taking all my medications as prescribed. I spend more time walking around the property and enjoying the beautiful weather.

There is a new job ahead of me. I’ll be looking after my great-granddaughter during the day. She is too old for day care and too young to be alone. I’m looking forward to spending time with her. I have lots of plans for little adventures. She will keep me active and alert. It will be a symbiotic relationship.
In the long run, I guess Riley’s condition really doesn’t matter anyway. Whatever is going to happen will happen without my consent, interference or management. It isn’t up to me. The only thing I can do is plan for my own future and not Riley’s – if he has one.

Friday, May 25, 2012

Do unto others...

I’m a big believer of family programs being offered when an alcoholic comes in for rehabilitation. I believe a solid program should be mandatory as part of the treatment plan. I also believe that any funding via government sources should be reduced if no family program is made available. I also believe that family programs should be covered under private health insurance policies that cover any alcohol treatment programs to the alcoholic. It seems to me that treating the alcoholic without treating the family is similar to removing a damaged appendix without closing the incision. It is a job only halfway done.

One of the misconceptions held by many caregivers or families of alcoholics is that there is some magic set of phrases or some formula that will prevent the alcoholic from returning to drinking. The reality is that there is no such thing. There is only a sense of “doing the right thing.”
I grew up with my grandmother always touting the Golden Rule. Whenever I was angry and wanted to “get back” at someone, I would hear her saying “Do unto others…” She had this keen sense of me wanting to kick over my brother’s truck or pour sand in his boats after they he had done some heinous thing like draw a moustache on my baby dolls face. She knew and she would softly say, “Do unto others as you would have them do unto you.”   Then I would see her scolding my brother and handing him a cloth to clean the baby dolls face.
Whenever Riley did something heinous to our relationship or to the kids, I always thought out ways to seek my revenge. But, I was never good at it. My attempts often were thwarted by my own hand. I resorted to reason and logic trying to use conversation to make him understand how insane his behavior was. I tried to get him to admit his wrong doings and often he did. He said he was sorry. He said he would try not to do it again. But, more often than not, the bad deed was repeated and I was left with frustration and anger.
I could always hear the words coming from my mouth – things like – he’s a disgrace to fatherhood or a miserable failure as a man or husband. I heard the words and I truly meant each one. But, in the back of my head was my grandmother… “Do unto others…” At those times I thought my grandmother, the strongest woman I have ever known, was just a wimp. I was not about to let some drunk get the better of me. I’d fix him – or tell him just exactly what my thoughts were at that very moment.
20/20 hindsight is a wonderful thing. I can clearly see now that I was not doing anyone any good. I ask myself now, what did I truly want? If I’m honest I would have to say that if he could not be the husband and father that I knew he could be, I rather he just left us. So, if that was what I wanted him to do, why did I not do that myself? Why did I not say – please leave and we can each be on our own?
I know why I didn’t leave for so long. The Navy gave us forced separations for long periods of time. I’m convinced it was the only thing that kept us truly married until I made the decision to not be counterpart anymore. There was also the practicality of it all – money and kids. There are many reasons why we do not leave and they are all very good reasons.
So in staying with the alcoholic, how much good does it do to belittle and badger? NONE! Would I want to be talked to in that manner – absolutely not. Doing unto others also means NOT doing unto them at all. Instead of all the mean hateful things I said, maybe I should have taken a step back and not said anything at all. Maybe I should have found another outlet for my ranting and venting.
Would anything I did keep him from drinking? NO!  Nothing I said or did could have kept him from climbing back inside that bottle. Getting back to drunkenness was solely his doing. I had no control over what he does or why he does it. I did not cause him to drink. He might have used me as an excuse, but this responsibility is his and his alone.
If that’s the case, then why am I so adamant about family programs? Because as the family and potential caretaker, we must come to know and understand that we have no control, that we did not cause, nor can we cure the alcoholism. The reason WHY the alcoholic started drinking or what makes them choose alcohol over the family is really of no consideration. An alcoholic drinks because he/she is an alcoholic. It’s that simple which makes it hard to understand.
Family programs can offer insight as to what to do next – after the acceptance that we are not to blame. They can teach us about detachment and offer a means to finding out just what the passion is that lives inside us all outside of the alcoholic insanity. They can remind us of the Golden Rule and they can provide valuable biological insight of alcoholism. If we know what to expect, we are better prepared for the ramifications. Knowledge is the key to survival. Family programs can provide that knowledge.

Saturday, May 19, 2012

Forgiving is not forgetting...

Riley is now at the nursing home and resting in a sparse room with bare white walls. There is window that looks out on the courtyard so he does have a view of the outside world. I’ve taken in a balloon bouquet, but the room still seems empty and cold. I thought my readers might be willing to help me brighten the place up a bit, so I’ve made arrangements for mail to be delivered to Riley at the home. If you want to help me turn those white walls into colorful expressions of thoughts and prayers, please send cards to:
RILEY RILEY
c/o Kindred Healthcare
901 South Halstead Blvd.
Elizabeth City, NC 27909-6920 

Today I’ll be going to visit and read to him from “The Wind in the Willows” by Kenneth Grahame. It was read to Riley and his brother when they were very small children. I think this might be comforting for him. If his mother were here, I’m sure this is what she would read to her little boy.
When I visited yesterday, Riley was actually looking a bit better. His face had filled out a bit and his complexion was better. I have been told that dying people do start to look better as they reach the end. I suppose its nature’s way of giving us a better memory of the last days.
Riley barely acknowledged my presence when I entered the room. He opened his eyes only for a second and promptly closed them again. I waited. A nurse came in and took his vitals. Then another gave him a bath. The bath woke him up. He was not happy that he was being bathed. His speech has degenerated to mumblings so I couldn’t make out the words, but I knew he was protesting. When she was done, she asked “Now… doesn’t that feel better?” I was sure I could understand him saying, “If you say so.”
Now that he was awake, I tried to make some light conversation. I mentioned that his room was nice and the bed looked comfortable. I told him I had talked to the staff and everyone seemed competent and caring. He mumbled something and opened only one of his eyes.
His nurse came back in and gave him some medicine. I’m not sure what it was, but he didn’t protest. He has difficulty swallowing pills, so the medicine was in liquid form. Before she left, Riley asked her for a drink. She said she would bring in some water. He clearly said NO followed by more mumbling. I’m sure he was asking for vodka and soda. The nurse told him “I’ll check on that” and left the room.
The thought occurred to me… why not let him have a little vodka? He can only get down a tiny bit at a time. He is clearly dying so there is no hope for sobriety. If it keeps him calm to have a few drops of vodka, what would be the harm? But, I kept quiet. I felt sure there was some kind of law or something preventing the precious liquid ever getting to Riley’s lips. Then again – I looked back at him and didn’t really see much agitation in his face. He didn’t need the vodka to keep him calm. Now I’m thinking is was some kind of “Pavlov’s Dog” reaction to just being awake and alive.
I’m not sure if “calmness” was what I was witnessing. I think it was more of a sense of resignation. He is out of options, out of choices, he is resigned to being in that bed and unable to do for himself. I don’t think he likes it, but is resolved in the knowledge that this is how it must be. I’m not sure if he has accepted the fact that his death is imminent. But, I’m sure he knows that this is not what he expected his last days to be like. He must be wondering – where’s the jealous husband chasing him with a gun and shooting him as he is jumping over a fence after catching him with the wife? Lying in a hospital bed is so mundane, boring, and without an interesting story for his legacy.
Besides reading to Riley, I will offer him my forgiveness for anything he may have done in the past that hurt me. I will also ask for his forgiveness for anything I may have done that hurt him. I will tell him that the kids love him and miss him. I will lie to him and tell him that his oldest son forgives him for the past. I will do or say whatever I have to do to let him depart earth as peacefully as possible.
I’m not so sure I really can forgive him or that his son will ever forgive him. Maybe in time the good memories will overtake the bad now that the bad will stop repeating over and over. I long since grieved the loss of the man who was my husband. All of this just feels like a formality. I am sad. I’m sad to think about the life Riley could have had if he had taken a different path. But, what is the point in that? It was what it was and it is what it is.

Wednesday, May 16, 2012

Just keeps on giving...

Riley is holding his own. He seems to be managing to keep death at bay for a while longer. The Veterans Administration has now taken over his case. Today he will be transferred to an approved nursing home where the VA will provide hospice care. This is good news for me because he will only be a 30-minute drive from my house rather than the 2+ hours to the hospital.

When Riley was admitted to the hospital, I relaxed a little. But, I was feeling under the weather and thought that I was just run down. I wanted to shut myself up in my room, but there has been so much to do with phone calls, arrangements, paperwork. Who knew that this would all be so complicated? I just kept plugging along and doing what I had to do.
Last Wednesday I was beginning to feel “flu-ish”. I wasn’t too concerned because I had heard that there was some kind of virus thing going around the hospital staff. It was a four-day thing and I assumed I had gotten it. Four days. I’d be miserable for four days and then it would be over.

When we were in the room with Riley we needed to be completely gowned and gloved. We were told it was because of germs. Uhhhh… yeah… kinda thought that but didn’t push for a more detailed answer.
By Friday I was really sick. I counted back and decided I’d be better in just a couple of days. I rested over the weekend thinking I would start working on my task list first thing on Monday. But on Monday I was no better than I was on Saturday. Now I was getting worried. It was time for me to do some research and ask my most trusted knowledgeable friends for their opinions.

There was some concern. Riley had previously been diagnosed with alcoholic hepatitis. I have had salmonella. I’ve been cleaning up after his bodily fluids for quite some time. It was possible that I had not been cautious enough during the clean ups. Now I was doubly concerned about the possibility of hepatitis. I went to the emergency room.

The ER was quiet. I was the only patient at the moment and that meant I got a lot of attention. The doctor took his time and actually remembered Riley being in there just a week prior. He told me that I most likely did NOT have hepatitis, but that since I had been exposed for so long, it would be good to run some tests. After a brief exam, he explained I was very dehydrated and needed to get some fluids into me. He ordered something for my tummy and headache. I lay back in the bed and waited for a nurse to start the IV.

I had drifted off a bit, but could hear a male voice saying, “Mizz Riley? May I call you Linda? I just need to get an IV started. I promise I’ll try not to hurt you.” I opened my eyes and thought I was surely in the wrong place. Looking down at me was a gorgeous face surrounded with long blonde curls. He had obviously spent some time in the sun. His bright blue eyes reminded me of my father’s. I must be on a beach somewhere rather than an emergency room. But the fantasy only lasted a moment when I was pulled back to reality as my eye-candy started searching for a viable place for an IV.

It took several attempts, but it was finally accomplished and a bag of fluid was now dripping into my arm. The lab tech came in and took some blood after failing several times to find a good place for extraction. Again, I could feel myself drifting off.

I could hear the ER starting to get more customers. There was an elderly woman from a nursing home that may have a kidney infection. Then a young girl who could not stop vomiting and then a man who became so weak while walking to the store, he had to call the rescue squad. It was interesting to hear the different stories and I was happy that no one had been hit by a bus or beat up by their spouse. They placed the newcomers at the other end of the examining rooms. I was essentially alone in my little wing of rooms.

The doctor and Blue-eyes came back in the room. Blue-eyes fussed around me while the doctor did some ‘splainin.

I had a gastrointestinal and upper respiratory infection which started out as that four-day thing that was going around. But, I was in a weakened, dehydrated condition. I had not been taking all my meds correctly and had been exposed to excrement.  Because I’ve had salmonella, I’m highly susceptible to stomach issues. All of that made my body the perfect place for that four-day thing to wreck havoc and breed and grow. There was no indication of any hepatitis – good news.

The treatment plan was for me to rest. I was warned that I was on the edge of being admitted. This thing can easily be upgraded to pneumonia or some other awful thing. So rest, have a BRAT diet (bananas, rice, applesauce and tea), pro-biotic yogurt, ginger ale, and lots of sleep. I was told NOT to visit Riley until I was well. I am NOT to attempt to clean either of the two rooms that may contain more of Riley’s nastiness. I was assured that this will be over in less than a week if I follow his instructions. I said I would.

He further explained that alcoholic hepatitis – while it IS contagious – it is the very least contagious of all the types. It would be highly unlikely that I would get it from Riley. Besides I take proper precautions when cleaning up after him. However, it does not hurt to have the vaccine and be tested every so often. Also, I should be tested for TB. He told me to wait until I’m over this and make an appointment with my primary care doctor. Don’t know why he wanted to wait, but I didn’t argue.
He also warned – again – that I needed to be extremely careful not to let myself get dehydrated. Also, to always stay aware of salmonella possibilities. Since I’ve had it once – it can keep on giving me issues for the rest of my life. Ahhhh… an end-stage alcoholic caretakers nightmare – salmonella and it just keeps on giving back!

While I was at the hospital, Alea had been fielding calls from the hospital, hospice, VA, nursing home. Some refused to give her information and others gave her details of what they needed. I was so very grateful that she was there.
Today, I know I need to rest. However – Riley is being transferred to the nursing home and I must go sign papers for his admission. It’s rainy and would be perfect for just covering up and sleeping. But, I have to go out. I’ll go and get it over with. I’ll be back before long and then – I’ll be in bed with my covers over my head.