Help for Healing

Bitter & Sweet, living daily with grief


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Witness of the Sacred

This weekend I had yet another opportunity and privilege to be a witness of the passing of another to the next world.

She was someone who was one of the moms that “adopted me” over the years, which is so special to me after losing my own. It was quite unexpected which brings its own complications to the grief process. She went in for a simple procedure and something went wrong. It happened to Tim’s mom. It reminds me of Tim’s supposed gallbladder removal and coming out with stage four cancer instead.

I walked away with my faith renewed in Buffalo General. The staff was wonderful. They showed genuine compassion and were straight forward and honest with the family. Professional but human, kind, competent.

Every time I go through a situation like this, I learn a few more things. Sometimes it’s about the medical system, procedures and practice. Other times it’s about relationships, loss, and the blend of unique and universal grief all mixed in together.

I cried briefly, but mostly was gathered together, even though the people I care about around me were in agony with the loss of the most important woman in their life. I actually started to worry, but then I remembered how it goes with me. True to form, in the thick of it I was present to everyone around me. Several hours later when I went to bed, it took about 15 minutes for me to blubber. Tim was ready and held me until my tears were done (for now).

It’s always hard to articulate what this experience is like. Words seem awkward, phrases feel inappropriate. But I was so proud of this family. All conflict was put aside and everyone allowed themselves to bond through their loss. In spite of the suddenness and the shock of letting her go so quickly, all were in agreement. No need to prolong her suffering.

As for mom? Well, it’s my personal belief that she is soaring in heaven with a now perfect body. She is free of aches and pains. I rejoice for her. For the rest of us? I pray for healing because the mourning is great. The hole she leaves behind will never be filled. It may scab over with time, but she is one of those that affect you for a lifetime.

And to her family, I cannot thank you enough for allowing me to be present during this very sacred time. It was an honor to be there, and it will continue to be a privilege to walk this grief journey with you, however little or much you allow my presence. Love and compassion to you all!


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The “Wow” Experience

Last weekend I started my first client managing/advocacy job. My initial meeting was in a hospital. It’s a large place with 16 floors, 71 rooms to a floor. As I found my way to her room, I had goosebumps. Out of the 1,136 rooms available, my client was in the exact same room my dad was back in December of 2017, 8 months before he died.

I’m not gonna lie. It was hard at first. I still miss him terribly. I’m anticipating Father’s Day soon and I know it will be hard. But I also had to admit this was more than coincidence. I was meant to be there. This is what I’m meant to do.

I was relieved because in my experience, this was one of the best hospitals I have interacted with. Now I have to take that back. It was an awul weekend and the worst was Monday (so you can’t blame it on the “weekend” staff).

The social worker, PA, secretary… virtually everyone we talked to with the exception of one male doc and one male guy at the desk, was nothing short of combative, argumentative, and downright wrong in what they were saying to us.

No matter how confident I am, when that many people beat you down, you start to question yourself. Thank God that night, my former spiritual director who was there with me, called to debrief. She said, “Wow! What WAS that??” I told her sadly, that was the typical medical experience. I was grateful to know she saw it as horrifying too.

That night I was in tears as Tim and I talked. Was this a mistake? Did I spend 18 months to get this job only to discover I didn’t have the guts to do it?

Thankfully, my client was transferred to rehab. I was nervous because it was the same company where my dad was at, but an entirely different location. When I arrived, it was clear that several mistakes had been made. Some insignificant, some more serious.

However, to my surprise, every person I asked to speak with showed up within 10 to 20 minutes. Every one of them- unit manager, physical therapist, aides, and especially the social worker- were respectful, listened, and appeared to want to follow through with what was discussed. (We will have to wait and see if things actually get done.)

I was so relieved. I’m not crazy. I can do this. I do know what I’m talking about. I’m not an agitating person. When you are dealing with folks who aren’t defensive and actually listen to what you are saying, it’s a peaceful environment. And that is certainly better for the patient.

Thanks to the staff. I can’t name you, but I pray your kindness will come back to you this week!


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Memo to the President

I was asked to put my concerns about Dad’s experience at rehab to give to some higher up person. It took me a while with how busy life is, but here is the summary. Hopefully, it will make others aware of what to advocate for if they are in our medical system.

“Thank you for taking the time to look at my concerns. The reason I have taken the time to put this together, is that I have a true concern and passion for helping to improve the quality of care in our medical facilities. My dad went to your facility on Saturday, Nov 25 of this year and I am hoping my observations will spark some changes that will improve future patients’ experiences there.

Overall, most of the staff were pleasant, which is important for people to feel comfortable. However, it is even more important that they are effective in giving patients what is needed. Overall, there is a severe lack of information available- for patients, their families, and even the staff. Every day I walked in and had to start an investigation to find out who Dad’s nurse and aide were. Not only did he not know, but it would take several attempts with different staff to find out as well.

A very simple solution would be to have small dry erase boards in every room like most facilities have. Rehab doesn’t need the large ones with tons of information, but just a small one for nurse/aide information. Having one in the nurses’ station would be helpful as well. Staff literally just looked at me and said, “I’m not assigned to him. I don’t know who is or where to look to find out.”

Another solution, would be to train staff to develop a much better attitude for helping. In other words, staff should really be saying, “I don’t know the answer but I will find out for you.” And then they actually find out and return with the information. This seems like common sense, but it was completely lacking there with the exception of one or two nurses that would put the effort in. I would literally spend a significant amount of time walking around your halls trying to find things out.

Along those lines, there also was no atmosphere of team work. Nurses would not do “aide work” even if they were with the patient. Aides wouldn’t help if asked if dad wasn’t “their assignment.”(And then they were unable to tell me who he was assigned to!) I have been with Dad in several facilities and a sense of teamwork is definitely possible. Not surprisingly, those few who were helpful, were also the same individuals that would find out answers for you.

Someone mentioned at one point that the schedule was supposed to enhance continuity of care. I honestly don’t remember two days in a row where he had the same nurse or aide, much less several days in a row. Perhaps it happened for a day or two, but it definitely did not seem like there was continuity of care.

At one hospital, at shift change, every nurse comes in with the next nurse on shift and introduces the patient to the nurse. That is incredibly helpful and creates a warm and safe feeling of trust in the care being received.

I recognize that some of my frustrations are part of the bigger mountain of a problem with the medical “rules” in general that seem to lack the patient’s well-being as the priority. When medical systems became businesses, the focus shifted on making money, away from patient health. It is maddening when you are a caretaker/advocate for someone and come up against this. Over 98% of patients do not have an advocate to help them. I have to consistently be the squeaky wheel in order to get simple things in place.

For example, I discovered (rather than anyone on Dad’s medical team) that he did not require a sling. This was crucial information that would change the entire course of rehab. I let the unit nurse know and she said she would check the orders and call who was necessary and get back to me. It was MY follow up that took several phone calls back and forth with doctors and your facility that finally got “orders” changed but it took two and a half business days to make it happen. That might not sound like much, but when it is your quality of life and treatment that is at stake, that can feel like a lifetime. One day after the sling issue was resolved, I arrived to find Dad wearing the sling again. He said “the woman said he had to wear it.” Of course, it took me running around the hospital to find out what was going on. I finally got to the nurse on duty who said she didn’t know who did it but they must not have read the orders. She had absolutely no concern in finding out who it was so it could be addressed. And she missed the point completely that medically, this was actually something that would set Dad’s therapy back if he continued to wear it. No follow through, no concern. And what if I wasn’t there?

Dad also came in to your facility with stitches in his head. I started the very first day of admission to ask staff to make sure they were removed on the day they were supposed to be. It took a ridiculous amount of bugging and nagging to make it happen. What needed to happen was that a doctor literally spend several seconds looking at his head in order to give permission to the nurses to take them out. Taking them out was only a matter of minutes as well. At one point, the excuse was that the doctor that was in that day, was not the doctor that could be billed for it. That is ridiculous. Again, the facility’s profit is the concern, not the patient’s care. The billing is not the patient’s worry. If your staff can’t take five minutes (literally) to do something so simple for the good of the patient, there is a very serious problem.

One morning, I arrived at 9:10 am to find my dad on the toilet, still in a hospital gown. He was furious. After investigating, I found out that the aide who put him on the toilet went on break, leaving him there and not telling anyone. He had been waiting quite a while. When there is no teamwork, the other staff isn’t going to answer a call light if it’s not their assigned room. I have no idea why he wasn’t dressed either.

The same day, I found his room in bad condition. The bed was a mess. The tray table had red thickened liquid dried on which couldn’t even be removed with soap and water. The same stuff was on the floor, also dried on. Urine was in the urinal, which causes the room to smell. Most disturbing of all, was the used diaper in the middle of the floor. I showed the room to the nurse who said she reported it. It was absolutely inexcusable.

Another time, I came in to find Dad’s dirty clothes lying in the closet in several places. There was no dirty laundry bag. I was doing his laundry daily so I set about trying to find one of the bags. I can’t even tell you the frustration with the amount of time I spent literally walking around the entire building trying to find someone who knew where the bags were kept. And because no one is in the mind set of trying to find things out for you, I went from place to place. After I finally got the answer, I actually returned to every one of the staff I had asked and told them where the bags were kept so the next person that needed one wouldn’t go through that.

One day Dad had an appointment off site. I was told transportation could be provided. I set it up, and thankfully, I got an erroneous bill before the appointment for another transportation cost. When I called to find out about it, they agreed it was in error, but informed me that the upcoming ride would be $110!! I canceled the ride and took him myself. The person who set it up didn’t seem concerned that I didn’t know. I would think that when you are providing services that are extra expenses, it should be protocol that the patient is fully informed before signing up.

Dad was discharged on a Saturday morning. I knew how things had gone, so I started preparing for this on Thursday. For two days I talked with several staff members to make sure that everything was in place. As a single mom and Dad’s primary caretaker, I had limited time and I needed to get him at 9 am. I checked and double checked with charge nurses and social workers. I was reassured repeatedly there would be no “hiccups” with discharge. The paperwork was ready, notes were left for staff, and everyone was informed. I stressed over and over how important it was for discharge to go smoothly.

I arrived on Saturday to find that absolutely everyone had paid me lip service. No paperwork was printed. No notes were left. The weekend staff had no idea he was being discharged and nothing was ready. I was in tears. The level of stress that caused me was totally unnecessary. It was sad that I felt I had to check and triple check everything days in advance because of the lack of follow through, but to find that I wasted my precious time anyways was infuriating.

I would be happy to discuss any of this further. My heart is not in the place of complaining for the sake of complaining, but for the hope that things can be improved. Your staff could do a much better job and have more satisfaction personally and professionally by taking better care of the patients in their care.
Thank you for your time.”

Darcy Thiel


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Medicare Mayhem

Dad fell last weekend and wound up with eight stitches on his head.

Then they figured out he had heart issues (which probably caused the fall) and he was transferred to another hospital and had a pacemaker put in. All of this was new to us so there was a huge learning curve. Plus of course it’s emotional to have a loved one with continued medical problems. Then you add the lovely medical system which is sorely lacking in common sense and it’s enough to drive even the sanest person crazy.

I keep a medical journal for my dad. I am going to share just one day’s entry with you so you can share in the madness. Of course I have changed the names to protect the guilty.

Wednesday:

Called Hospital G to ask them to give the surgeon’s assistant my phone number in case she saw Dad before I could get to the hospital.

Surgeon’s Assistant E called (Yay! She got my message!) and said that dad should be ready for discharge sometime today

Called Assisted Living (where Dad now lives) to let them know Dad would need his stitches out.  They said, “They don’t do that there.” I told them the doc at ER told me that assisted living usually handles that. They said they would have to get back to me. Also said they could help dad with getting dressed, etc. because his arm will be in a sling for six weeks but they would have to charge extra.

Called Assisted Living again to ask why scripts require a two week notice, also asked about the stitches; she said she would voice my concerns to the correct people and then have them get back to me.

Nurse S, hospital charge nurse from Hospital G called; said that dad had been evaluated by PT and was unable to walk properly, even with a walker; he would not be released and needs rehab; crap!  he will miss Thanksgiving 😦

Social Worker J from Hospital G called; told her I had heard the news; she said the problem is that medicare would not pay for rehab so it would be all private pay; I asked why and she said he needs to have been in a hospital for 3 overnights to qualify; I reminded her that had been transferred from Hospital M; she said the problem is that his status was “observation” which does not qualify; she was going to do some research and get back to me

Called Hospital M’s president as I had met him the day before; his assistant answered; I told her the situation and asked if they could change his status; she said their patient advocate was on vacation this week; I needed to call Patient Advocate L from Hospital Ge and she would communicate with the right person

Left message for Patient Advocate L and paged her; continued to do so every 30 minutes

Called the number I had for Medicare; 30 minute wait so I left a message

Patient Advocate L called back; said the criteria for hospital status is very strict so it can’t just be changed; if they do, we could end up having to pay for the hospital stay too; said she was going to pull in Head of Discharge Planning M to get a team together to try and find a solution

Social security called back; I had the wrong number for Medicare; called Medicare and they said that acute inpatient rehab (in a hospital) is covered by them and does not require a 3 day stay; sub acute skilled nursing facility rehab is not covered without a 3 day hospital stay; I asked if there was an appeal process and she said no

Talked with Nurse S about this information; she said Dad would not have the stamina for hospital rehab; it is at least 3 hours of intense therapy daily

President’s Assistant at Hospital M called back with another name because I had left a message for her saying Patient Advocate L hadn’t called back; I told her I didn’t need it and a team was working for us

Talked again with Nurse S; she said that if I took Dad home with me, he would need to be watched 24/7; she could set up services at home if his primary doctor (who is at Assisted Living) would write the orders

Assisted Living Head Administrator S called back to address my concerns; she said that express scripts requires time to deliver and that’s why it needs 2 weeks; I explained that wasn’t what I was talking about; I was referring to Assisted Living Doc J ordering scripts from them on the day I ask for them; it wasn’t happening; she said Dad would probably require assistance with dressing, shaving, etc. because of the sling for 6 weeks and I asked her for a ball park rate of how much that would cost; also, explained that we needed orders for rehab if he came to my house; said she would have to call back

Nurse S said the team made Dad’s status in patient as of today; if he stays until Saturday, medicare would pay for rehab

During all this time, dad was extremely out of it; I found it he had taken a narcotic for the pain (which explains it; he reacts very strongly sometimes); he was sitting in a chair, bent over sleeping; at one point he woke up and asked about the macular degeneration grid he uses for his eyes; I asked Nurse S about it and she wasn’t familiar with it; I suggested she google it; she did and printed him up a grid.  Then it occurred to me that if he took the meds before the PT evaluation, that could have effected his walking; I talked to the staff but they insisted that he was alert and that had nothing to do with it; I disagreed, but there was nothing I could do about it so I dropped it (Common sense tells me that if the meds had him drooling on himself for five hours, it probably effected his balance while walking, but I got the ‘ol “WE know cardiology patients” stuff… Well, I know my Dad!!)

Social Worker J called back;  I had asked her to look into Dad’s secondary insurance; she did and they will not pay for rehab either; rehab is $490 a day and requires a 7 day advance payment before start; I told her that the team had changed Dad’s status; she said no one kept her in the loop and that is not an option and we might also end up paying for the hospital stay; she said she would discuss things with Discharge Planner M and get back to me

Assisted Living called back with the administrator and social worker on the line; they said they felt that the best option for dad was to be released to them and Doc J would write an order for rehab there; I (or family) would have to come at least twice a day to assist dad with dressing, undressing or else we would have to pay; 2 showers a week is $150/mo; the rest would be $300/mo, ballparking about $450 extra a month; I said I would have to discuss this with the team and get back to them

Surgeon S’s office called to set up a 2 week follow up appointment

Talked to Social Worker J; said she is out of the loop now; Nurse S is the one who will follow up

Nurse S said that Surgeon S’s assistant noted that dad’s blood pressure dropped; this is a legitimate qualification for status as an inpatient stay; he will be moved to another part of the hospital in the general population vs. the cardiology unit; if he stays until Saturday, he will be eligible for rehab being paid for (Now how is that for common sense? Now we are hoping dad DOESN’T get well so he has to stay in the hospital long enough so that insurance will pay for the services he needs!)

In between all of this, is the rest of my life.  Call from a school social worker to discuss a client I have.

Call from my client; I forgot her appointment; started crying because I really, really needed the money this time; she was great about it, but I felt awful

Sent 33 texts to try and get rid of my sabres tickets for last night because Frankie was already going with a friend; too exhausted to go but seats were $150… ended up going so they wouldn’t be wasted…

All said and done, I sat Thanksgiving morning and counted all the phone calls I had the day before, just for giggles. Wanna guess? 59!!!

No wonder I’m nutso…lol

But here is something nice. When I finally left the hospital last night, I was crying on the phone out of exhaustion and frustration, talking to my sister. The parking dude told me I didn’t have to pay the 7 bucks that I usually have to pay for parking. I told him thank you and I planned to cry every night so he would let me off the hook. He smiled at me.

 


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Endings

If you want to read the precursor to this story, check out “Shut Out.” The end of the story is not a good one and I wish I could say it isn’t so.

One of the days that Ed had texted and asked me to visit him and his daughters asked me not to come, I reached out to someone at Roswell that I had met who worked with “family engagement.” While I wasn’t sure what that is exactly, I wondered if my situation would fit in. I forgot that I called him, but a few days later he got back to me.

I told him that I had decided not to go to the hospital, but I said I would be interested in knowing what his opinion on the situation would have been. He went around a few times, but actually called me back later and said that the bottom line is really about the patient’s wishes being respected. While we both understood that accepting death is difficult and some families just refuse to go there, it wasn’t about that. It was about Ed. He suggested that he talk directly to him and find out what his wishes were. If he indeed wanted me to visit, then perhaps the social work department could get involved to help the family shift their thinking about how best to support their father.

I cautioned him by reminding him that the family believes they are doing the right thing for him so this would be an extremely delicate situation. It would have to be handled ever so carefully. He agreed and said he would get back to me.

He didn’t. Instead, I got a scathing text from one of the daughters that was addressed to me, and copied to the other siblings. It spoke of how disappointed she was when a social worker approached her because her dad’s counselor and called to complain that his family was keeping her from seeing him. She told the worker that I was not his counselor, etc.. She also went on to talk about my creating nonsense at a time when they are focusing on his well-being.

I was stunned. And angry. I texted them all and said that it was not true and that I had their father’s well-being in mind at all times. I told them I would like to sit down and talk with them and straighten things out because it’s much too important to text about.

I never heard from any of them again. I texted. I called. I left messages. I texted and called Ed but never got responses. I didn’t know if his phone was being monitored or if his family had told them I lied to the hospital and they all hated me.

I thought and thought about how to let him know I cared. I have several cards he’s sent me over the last few years where he called me his best friend. I would dare say I might have been his only friend. This was horrible. I decided to send a card to the hospital.

Only he wasn’t there anymore. I started looking for him in various rehabs that we had talked about as possibilities for him to go to. I peppered the search in between the calls to him and his daughters.

This weekend I found out the truth. I found his obituary. He was gone. And his wake and funeral were over as well. I reached out again to the family to ask where he was buried. No response.

To say I was devastated doesn’t really describe it. It was such a complex ball of emotions. Of course there is the loss of a very, very dear friend. There was shock that this family despised me this much that they wouldn’t even let me know about the wake. I know in my heart I absolutely did not one tiny thing wrong to deserve their hatred. Not one. And now I’m also experiencing a great deal of anger. I’ve had boatloads of loss in my life and I absolutely did not need to have a loss that was the result of a bad ending.

And then there is the anger at myself. Because I have been so depressed lately, I chose not to go to the hospital because I just didn’t have the strength it would have taken to stand up to the family and honor his wishes. If I wasn’t so depressed, I would have taken my strong patient-advocate self. But instead, a wonderful man asked me to come and he died thinking I ignored him.

I have always said beginnings and endings are crucial in life. You can’t have one without the other either. I was thinking about how sometimes people behave badly and then at the end of their life, they make peace or say they are sorry. The ending changes everything. Maybe it shouldn’t, but there has been lots of forgiveness that happens at the end. And I say hurray for that.

I realized that I assumed the reverse is true. If the ending is bad, it negates any good that happens before that. Darren reminded me that is not the case. He said the months and years before this ending, I was a good friend to Ed, and he was a good friend to me. Good enough for him to call me his best friend. The ending was only a small space in comparison. When he was lonely and sad when his wife was in the nursing home and then eventually died, that is when I was there for him. I mattered to him.

Thank you, Darren. You are so right. The reverse is absolutely not true. While the ending was sad and unfair, his daughters can’t take away the years of our friendship. All of the walks, talks, hugs, fires, and pool parties meant something. I love you, my dear friend. I am just sorry I wasn’t able to tell you one more time.


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Millard Suburban

Part of my new career is talking about death/dying and grief/loss, and part of the goal is to help improve the medical system. I admit, I am hard to please when it comes to hospitals and doctors. It’s not because I’m cynical and picky, but I do honestly believe that our system is very, very broken.

When I went to Punta Cana for four days, so many people told me I needed to go for a whole week. Boy, would I love that. You barely get time to drop your guards down and it’s time to return. But I’m a single mom, a therapist, and I help take care of my dad. I just feel like I can’t be gone longer than that. And sure enough, there was one client emergency and my dad ended up in the hospital. Sigh.

Anyhow, I have to say, I love Millard Suburban Hospital. Dad has been there three times since April. Of course no person or entity is perfect, but I really like these guys. When I got the text about Dad, I started in right away. First I had to handle a situation for Frankie because obviously Dad wouldn’t be staying with him if he was in the hospital. Next was sorting out what was actually going on. Dad does his best to understand the medical stuff, but sometimes things get mixed-up. Everyone who was local was visiting him and trying to talk to doctors, but there was some confusion.

I called the hospital and explained my dilemma of being Dad’s medical advocate (as well as legal and financial) but that I was out of the country. I got a call back from the nurse practitioner. She remembered me and Dad from October’s stay. I immediately felt better. She did her best to explain what was going on. She also said he was stable and I didn’t need to get on a plane and come home. She also said she would call every day and let me know if there was any change.

She did exactly that. She even remembered to say “Happy Birthday” in her message on the day of my actual birthday. (She is turning 50 this year too!) She also had the surgeon call me directly. He explained things to me even further. He was able to clarify some of the more confusing aspects of what was happening, which turned out really just to be a clarification of terms. I told him that I was returning home Tuesday night but not until midnight. I asked if there was any way to keep Dad there until Wednesday so he was not released to his apartment where he lives alone. No problem.

He did exactly that.

I really appreciate this hospital. I figure I do enough complaining about all the bad stuff that happens, I wanted to acknowledge the good stuff that happens. I think I would like to go there if I ever have the need to be in a hospital. Thank you to all the staff who took such good care of a man who all of his family love very much. And thank you for bothering to care about a 50-year-old who was on a much-needed break. You put my mind at ease, which all the beautiful paradise-like sun in the world couldn’t have done if I was worried about my father. Kudos!

(P.S. For those of you that follow me on Facebook, yes! This is the same surgeon that I met in person when I got home and could barely concentrate because he was so handsome… Just another perk of the hospital!)


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Miscellaneous Tidbits

I wrote a blog about losing stuff, and I forgot to mention the one positive. I have NOT lost my sense of humor. Thank God.

Last week I was driving Dad and I home from Lockport. That’s about a 45 minute drive home and I’ve made the drive a million times. We stopped at Millersport Market so I could pick up a fabulous dinner for Colin’s 33rd birthday. It wasn’t exactly cooking, but it sort of was. I had just enough time to get home, get it in the oven and eat before we had Frankie’s first hockey game after being laid up on crutches.

After a few minutes, I looked at Dad and told him I was feeling confused. I couldn’t get my bearings. Where was I? I knew I was on the expressway but suddenly nothing looked familiar. I studied the signs and realized that somehow I went east on 90 instead of west. How the heck did I do that? Well let me just tell you, it is 17 miles before the next exit. I had to drive all the way to Pembroke before I could turn around. That’s 34 miles out of the way. At first, I was teary-eyed, telling myself what a sucky parent I was. How hard is it to make a dinner for your kid’s birthday? Impossible for me. But then Colin called and said he wasn’t home anyway so we decided to have the dinner the next day. Dad and I joked all the way home about the scenic drive and the chance to spend some quality time together.

Yesterday, Dad got a phone call. He put it on speaker. The woman said she was from the company he used to work for and was following up on the hearing aids he got. His insurance had this amazing deal where he got hearing aids for free. They usually are 3-4 thousand dollars so it was quite a thing. Dad just looked at me in utter confusion. I explained what the call was. They wanted to do a survey with him. I then said into the phone, “He can’t understand what you are saying because he ISN’T WEARING HIS HEARING AIDS!” We laughed our butts off. He doesn’t wear them most of the time which is quite convenient when he wants to block us out :).

Then we had to go to the eye doctor for Dad. Most of the patients in there are older. It’s only a five-minute appointment with the actual doctor. But you see two other people first for various tests. This one older guy gets picked up and I hear the nurse say, “Oh, ha ha. I was waiting for the joke. I knew you would have one.” Never fear, I got to hear the jokes before the morning was over.

What did the cookie say to the doctor? I feel crummy.

Why does a hummingbird hum? Because it doesn’t know the words.

Cute. Very cute. Until the third and fourth time I heard the jokes. He told them to everyone. I wanted to tell him he needed some new material.

Then Dad and I went back to Lockport to see my sister in the hospital. (No, smart alec, I didn’t drive all the way to Pembroke this time. But you can be sure I was not on automatic pilot. I paid attention to every turn I made!) She has a blockage in her pancreas. She is being transported to Buffalo General today. They will do a procedure where they explore the blockage. If it is gallstones as hoped, they will be removed. If it is a mass, they will do a biopsy. After the procedure, they will determine the next step. She hasn’t eaten anything, or even had ice chips since Sunday and it’s now Friday. At least she is not in excruciating pain anymore.

In her room, her surgeon drew her a lovely picture of her inside organs to explain things.
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We got talking about what NPO means. I knew it meant nothing by mouth, but we looked up what the actual meaning is. Turns out it’s Latin for “nils per os.” So that became the game, asking nurses who walked in if they knew what it meant. Not one person knew. I know a nursing student who is taking his last finals before graduating. He didn’t know either. I’m so proud. If the question is ever on Jeopardy, I’ve got it covered.

But the most mature joke of all, was that picture. Now honestly, doesn’t that look like a penis at the bottom? I mean, not a good picture of one, but at first glance? The nurses agreed. My sister’s roommate is about a million years old. I don’t think she thought the joke was funny. Dad didn’t mind. But then, he didn’t have his hearing aids in so he probably didn’t even know what we were saying.

By the way, that is supposed to be her pancreas.