Renewed

I can’t say I’m sad to see 2018 go.

It was a difficult year, to say the least. A few days into January, my father  had his first fall and we realized that my mom probably wouldn’t be able to care for him at home for much longer.  Over the span of a few months, there were more falls, more calls to 911 for assistance to get him up off the floor, and my brother and I convinced our mother that a retirement home was the next step.

I thought I was handling things well but by June the writing was on the wall for him. Darkness, the black hole of depression, started to consume me and I was failing everyone.

The year ended better than it started.   I worked my ass off at two jobs and kept very busy mostly to avoid thinking about it all.  I know that doesn’t sound like a good thing, but really, it was.  The only downside was that I basically stopped running.
But 2018 is done now, and so is the extra work and on new years’ day, I went for a goddamn run. It was glorious.  The sun was shining and despite the chill in the air from the cold wind, I think I was smiling inside the whole time. 
Hello, 2019.  It’s nice to see you.



I’ll be Damned.

I have a decision to make.

Do I vote yes and be complicit in accepting a 4 year agreement that knowingly under funds health care and continues to reduce my income;  or do I say no and be subject to further unknown unilateral fee cuts for the foreseeable future.

Not so easy a choice is it?

Better to be screwed facing your attacker? Or better to be blindsided from behind?
Because that’s essentially what the physicians in my province are facing.

Damned if we do. Damned if we don’t.

I am not political. Never have been and really, never want to be.  But I just can’t stay quiet on this any longer.

I am being asked to trust a government that has grossly mismanaged health care for years now and wastes taxpayers money on scandal after scandal.

I am being asked to help manage utilization of health care resources.  What does that mean? Do I tell a patient that they can’t have that ultrasound because we have exceeded the budget for that month?  Do I close my office one day a week because I am exceeding the budget for that month? Do I tell my staff to take an unpaid vacation day once a week because I can no longer afford to pay them for 40 hours of work anymore?

My head hurts.

A Bad Week.

It’s Saturday night, I think. Honestly this week has been a blur. I feel terrible complaining because I know for a fact there are others struggling with a lot more this time of year (a few of them are my own patients), but I have to say this has been one of the crappiest weeks I can remember.

It started off with me getting some kid of flu/GI virus that decimated me for close to 36 hours, then I get the phone call that my dad is going to the ER and after spending 15 hours at the hospital he gets admitted. I missed seeing a theater performance of Cinderella with my daughter and my aunt that day. (I’m still really bummed about that).  When I got home that night, around 1am I found my husband in bed with shaking chills. He spent the vast majority of Wednesday in bed. Despite exhaustion, I took my older kids to an indoor play center to blow off some steam. Later that night my brother, wife, stepdaughter, and my best friend came over for an already-planned Christmas Eve-eve dinner. Husband and I were exhausted but it was wonderful to have family over and they helped out by wrapping all of our kids’ Christmas  presents.

Christmas eve saw husband going out for last minute gifts, still unwell.  I took one of the kids to see Pappou in the hospital. The kids watched Santa on Norad as he made his way from Morocco to Ireland, we set out milk and cookies for him and the kids went to bed with zero fuss.  Husband and I settled in to watch our annual holiday classic, “Die Hard”, and promptly went to bed around 10pm.

Christmas morning the kids were up early, as expected.  Christmas gifts were opened in a frenzy.  I had planned on taking all the kids to see Pappou in hospital, so after breakfast everyone got ready, except husband who was still not feeling great.  Over the course of the morning, my older son, the 4.5-year-old, started complaining of a tummy ache.  He barely touched the apple juice he got from my mom, nor the donut.  He looked pale and complained even more about his tummy so we left the hospital after a short visit.  The entire car ride home the little guy was moaning.   As soon as we arrived home, he was curled up on the couch with his new Star Wars blanket.  Ten minutes later, he’s running to the bathroom calling for me and threw up.

Merry f*&king Christmas.

We were expected at my brother-in-laws house for Christmas dinner later that evening.  I called my mother-in-law and told her everything. I wasn’t sure we should bring my son so I warned her that he and my husband may be staying home.

As it usually is with stomach flu, once you throw up you start feeling better.  My son seemed to make a pretty fast recovery and I spent the afternoon watching him build Star Wars Lego. The 7-year-0ld was happily entertained with her new Nintendo 2DS from Santa.

Later that afternoon, with the two boys (husband and son) feeling better we piled into the car and headed west to my brother-in-law’s house.  We were going to arrive about 2 hours late, but I had called my mother-in-law to explain.  When we were about 10 minutes away I suddenly remembered that we, well I, had forgotten the dessert.  Among the chaos of the week, I had gone out to buy two pies and ice cream as we were expected to bring dessert.  We found an open Shoppers Drug Mart and were saved.  Cheesecakes and eclairs to the rescue.  (Seriously though, could this week end already?)

Christmas dinner was lovely.  Husband and I ate but neither of us were particularly hungry.  For me it was likely due to the stress of the week, my appetite has been shot. For husband, well, he was still recovering from the illness.  An hour after dinner, my older son started turning pale again and complained of his tummy hurting.  With profound apologies, we piled back into the car and drove home.  Thankfully he wasn’t sick in the car but he did fall asleep and didn’t wake until almost 9am the following morning.

Boxing Day.   Another trip to the hospital to see my dad.  A relatively uneventful day and I was beginning to think the worst was over when the 2-year-old started screaming.  Husband went to see him and called out – “He threw up.”

OMFG.

That poor little boy emptied his stomach over the course of the next 5 hours.  I slept on a cushion on the floor of his room and he finally stopped dry heaving at 2am.  He was awake at 6:30am as if nothing happened.  Meanwhile husband is curled up in bed, moaning.

Stomach cramps.

What the actual f&#K?

I’m ready for this week, hell, this year, to be over.

Only one person has been spared so far … my daughter.

Pray for me.

 

About those kids… 

It’s two days before Christmas. We haven’t quite finished getting the kids’ presents and nothing has been wrapped. 

I had a fitful 4 hours of sleep last night while husband lay next to me with the chills. As if things couldn’t get worse he is sick with whatever flu-like illness I had a few days ago. 

The kids have been cooped up so this afternoon I took them to an indoor play center so they could run around and you know, be kids. 

On the way there, I told the older kids that their Pappou (grandfather) is sleeping at the hospital and that I was there very very late last night when they were sound asleep. Of course the older one asked why and I tried to explain. 

My 4.5-year-old son: “Mommy you should have told me you were home. We could have talked and I would have gone back to sleep.”

The 7-year-old daughter: “Wow, mommy that sounds like a long day.”

Sometimes I underestimate my kids. They understand a lot more than I give them credit for. 

Just A Daughter

I’m really trying very hard not to feel like a complete idiot right now.

I attended another appointment with my parents today. It was a follow up with the physician that made a diagnosis last year of minimal cognitive impairment (MCI).  Since we were seen there last year there’s been some worsening of his memory and behavior and we were assessed by a different neurologist to rule out a structural brain disease called Normal Pressure Hydrocephalus. It was at that appointment a few weeks ago that the diagnosis of Alzheimer’s dementia was made.

At today’s appointment I sensed a bit of push back from the geriatrician as to why we were seen at a different clinic.  After explaining, I then asked her a few questions about disease progression and whether starting medication last year might have helped. I didn’t think I was being critical but when the physician turned to me and asked, “Well, you’ve read the literature, right?” I felt like she went on the defensive. I said I had, (and I had read about minimal cognitive impairment last year!) she asked me what I remembered.

Um, excuse me? This wasn’t a teaching moment. I’m not her resident. I’m asking as a daughter, not a physician.  I couldn’t believe she was treating me that way, and in front of my parents.  I don’t care if she was pissed off that we went to another hospital and got a diagnosis, she had no right to treat me like that.

I was honest and said I couldn’t recall. She then answered my question. 10-15% of patients with MCI progress. Sadly my father is one of them. And starting medication earlier would not have been indicated. In fact it could have made things worse. As she related the information to me it started to come back. Still, I felt stupid for not remembering it and even more stupid for asking the questions.  All I can see is my dad and his diagnosis. I should have the intellectual capacity to look clinically at the literature and apply it to my dad but you know, I can’t.

I’m just his daughter today.

I debriefed with my colleagues today and they agreed that it really wasn’t appropriate the way the specialist treated me. I have to get over my anger because this is the person who will be caring for my dad. I have to find a way to put it behind me. But right now, I can’t.

 

 

The Sword

Day 30 – National Blog Posting Month. 

  
Well, here it is. The last day of November and the last day of daily posting for a little while. 

My heart and mind are heavy. It’s been a busy weekend and an emotionally exhausting one as well. I’m finding it really hard to focus and am constantly thinking about my parents. I know that my worry will not go away and that I have to find a way to manage it. The doctor in me tells me to research and learn all I can but the daughter in me can’t bear to carry that knowledge. Now there’s a double-edged sword if I ever saw one. 

Physician Heal Thy Parent

I was up at the crack of dawn this morning (what else is new?) but this time to take my dad to a specialist appointment. We are the first ones here, even before the receptionist!

Since I have taken over this role of being present at most of my parents’ various specialist appointments, I have come to enjoy watching another physician do a physical examination. It’s a great refresher for me, especially the neurological exam. This was my nemesis in medical school. It is probably the most complex sequence of tests and observations I have ever had to learn and I still feel like I never mastered it.

Today I witnessed a skilled clinical fellow perform a thorough neurological examination on my dad.

I knew everything she was doing and why.  There were tests I had forgotten about, ones that are very specific and others more general.  At the end of the 3 hour appointment, we had some answers and now a few hours later, I have nothing but questions.

I need time to process. I know the road ahead of us. I’ve seen patients and their families go through it.  It’s not what I wanted for my parents, least of all my father.

But this is life.  It is hard. It is ugly. It is rewarding. It is love.

 

Required Rest

Day 22 – National Blog Posting Month

Well it’s been almost another week since I’ve run. I guess my body really did need the rest. Haven’t really been needing to run despite feeling kind of gross with my clothes feeling tighter this week. Meh. Whatever. Honestly, I really shouldn’t complain and I know that. 

Anyway, my girlfriend texted me yesterday to see if I was running today and we made the plans for an easy 5 km run. It was a gorgeous morning and a bit cool so I was happy to wear my new bright running jacket. Little did I know that I would be clashing with the new shoes too.  

We set out doing 10:1 intervals and our pace was pretty good. As we started out second set my friends knee starting bugging her so we slowed to a jog then walked. Our plan for 5 km fell short as we were only able to do 3.55 km and the last kilometer we had to walk. Honestly I was fine with that. It was nice to catch up and talk without feeling like I was going to throw up as I normally run alone so don’t usually need to talk to someone. 

It’s pretty clear to me that my. Indy has been telling me to slow it down since the half marathon so I’m going to listen and take it easy.  I could use more time to work on my cross stitching anyway. 

Teeth.

Day 20 – National Blog Posting Month

Those are my teeth. Aren’t they pretty?

So yeah, I went to the dentist yesterday. The last time I went I was four months pregnant with my daughter. Yes, that was 7 years ago.

Did I mention that I hate the dentist?

The last time I went I needed lots of freezing to clean my teeth. Apparently I am prone to plaque buildup and since it had been oh, about 10 years since I’d seen a dentist then, I had a lot of buildup.  Gross. I know.

Anyway, so I decided I had to get my teeth cleaned as I started having more dreams about my teeth falling out and disintegrating in my mouth. My husband teased me that I shouldn’t need freezing.  I’ve had three c-sections, I should be able to tolerate an hour of scaling right?

My brother on the other hand, needs a benzodiazepine, freezing and laughing gas to get his teeth cleaned.  We are a pair, aren’t we?

Anyway, I remember as a child going to the dentist a lot. I hated it even then. I don’t know if it was the smell of the office or the fact that I was getting fillings, it felt like, every single time I was there. The office was in a house. I remember it so clearly.  I needed braces when I was a teenager and once they were off I think was when I stopped going. I was done.

My current dentist is a woman and she is lovely. She suggested we try the cleaning without freezing to see how I do.  She used something called the cavitron. It’s a scaling tool that uses ultrasound to break up plaque, or something like that.  She started and it was actually okay.  She managed to clean a hell of a lot without an ounce of freezing.  She was very sweet and kept telling me how amazing I was doing.  There were a few spots that were super sensitive, but overall it wasn’t nearly as bad as I had expected and bonus for me not be frozen for hours thereafter.

Today my teeth feel weird. Like I can actually feel the grooves between my teeth weird. But I am needing some Advil because they are really, really sore.

Oh and the extra bonus?  No cavities!

Yay me!  Bring on the candy.

Er ….  😉