My desire for a new tradition will have to wait until next year. Yesterday afternoon, I began sneezing. I don’t sneeze usually. That is, unless  I am coming down with a cold.

I thought that it could be an allergic reaction…not. I worked 10 hours and had been up 18 hours and I thought that I was just tired. I had so much to do, so I kept pushing myself until I realized I had no energy left in me. I had to lie down.

I laid down on the couch and was awake again at midnight. I was coughing and sneezing I couldn’t breathe very well. It wasn’t an allergic reaction. Instead of a lump of coal, it is a virus…a cold.

At 4:30 am, I knew that I could not expose my sister, my family, friends and a church full of people to whatever this virus. There is too much flu and there is always the H1N1 to consider.  I don’t have the heart to be such a “Grinch” and steal good health from folks just because I want my Christmas celebration.

I texted everyone at 4:30 this morning and cancelled the late night supper and the plans for me to attend church. There were several of my friends that I invited and they were going to go with me. 

I am in no condition to prepare food or be in the same room with anyone. My Christmas isn’t cancelled, but my plans are. My new tradition will have to wait…

My biggest concern was my sister. She lives in a group home and things like this goes through the house like fire. My heart was breaking. She is confused a lot of the time now. But, she knows that everyone is going home to their families and she will not understand, or so I thought.

I called the group home at 7:30 and explained my situation and my older sister’s present-day demands. Her father in law was in the local hospital having surgery at that very moment. I explained to the staff at the house that I needed to talk to the person who was in charge of the house to make the next best arrangements for this holiday.

I also wanted to make sure that my sister would have presents tomorrow. That was bothering me the most.

Lately, my younger sister thinks it is Thanksgiving and I thought that we could slide by the day of Christmas, but I could not stand the thought of her being without presents to open tomorrow. So began the next hour or so of alternative planning for my sister’s Christmas Day, tomorrow and her visit home.

One of the staff members will be taking my sister and another lady to their home for Christmas Day. The person in charge of the home was going to go shopping for a few presents for under the Christmas Tree so my sister will have them to open just like everyone there.

As it stands now, I will try to have my sister here on Saturday through to Monday. I am praying that whatever this is will be more done than not and that I would not be such a “bag of germs”.

That means that sometime tomorrow I will have to disinfect this house and make sure that the surfaces are not contaminated with this virus. I am praying for a Christmas Blessing for a quick end to this “bug”. It isn’t what I wanted for Christmas this year, but, for some reason, it isn’t meant for me to have my new tradition this year. And, somehow, it is OK. Most likely, it is because I physically feel so badly.

I will celebrate Christmas anyway, I will, I will….just not with friends and family.

As one of the first of Christmas Blessings, I received a wonderful Smilebox from my friend, Frank…I love his vintage Christmas Cards and the choise of music.

Thanks, Frank..

And thank all of you in blogsphere who have come to me and I, you over the past couple of years. Thank you for helping me walk this road of loss. Your comments and support mean a lot to this wounded heart. And, because of your kindness, my heart is healing.

My God Bless You and Grant to You a Wonderful Christmas and a Bright and Happy New Year!!!

In light of the missing desire to write, I realized that the lack of writing has retarded my recovery from Dan’s death.

My heart is empty so why am I surprised that the posts are missing? My grief counselor noted that my writing helped me with loosing Dan on a daily basis.  Now, that I do not attempt to write, my recovery from loss is at a stand still.

I don’t know just how much I can squeeze anything out of my emptiness, but I do know that my lack of desire to write doesn’t indicate a lack of issues in my heart.  I need to write more now than ever.  It is the same pain and that seems to tranlate into the same words. I don’t write because I feel that I am redundant.

The Basement experience continues to reveal more things that I hid from myself and it took that event to help me understand that I was content to live my life “underground”. That is definitely not where I want to live nor do I have the luxury of living in a withdrawn state of mind.

The quote from the movie Shawshank Redemption has taken on a daily reminder. “Get busy living or get busy dying.” I believe that I was only wanting to hold still. When I do that, my circumstances always take the initiative and makes choices for me. Realizing my lack of action has left me without any satisfaction, circumstance becomes my decision maker and the frustration within myself builds.

I know better in my head. It is my heart that wants to keep any forward motion at bay. I know that I will not like what inertia brings to me.  My life experience has taught me that  non action  leaves me in a miserable state of mind.

So, what to do now?

I need to make a new tradition regarding the holidays. Recent events will change Thanksgiving. My dad’s family has always gathered on Thanksgiving. It was a feast and a time to see aunts, uncles and cousins that would not be seen until next Thanksgiving or at a wedding or a funeral. I can’t remember a Thanksgiving with my immediate family. It has always been the extended family and, with that, my cousins became  as brothers and sisters to me.

This past Thanksgiving, an aunt and an uncle were diagnosed with cancer. The prognosis for one is better than for the other. One family will be devastated by this time next year. The disease is very advanced and palliative care is the only treatment offered. The other has a brighter prognosis and another family will gratefully give thanks for being spared the heartache.  The health of the dwindling few will chang the  way that Thanksgiving has been celebrated for over 60 years.

My sister is also one that has limited holidays left. Her dementia is advancing at an alarming rate. What to do with her health and insuring a quality of life for her has become a priority for me and my older sister. We will have difficult decisions to make regarding her care as the disease progresses. The holidays will never be the same without her.

For Christmas, my tradition was always on Christmas Eve. It has always been a magical time. As a young girl, I loved being in church at midnight on Christmas Eve. It seemed to make Jesus’ birth the center of everything for me. Christmas in church made the meaning of gift giving more than commercial success. Remembering His Advent made Christmas and the joy of it real to the very depths of my heart.

Unfortunately for me, the church denomination in which I was raised did not have Christmas Eve services. The times when Christmas Eve fell on Sunday evening became my favorite Christmas’. Being in church satisfied my soul hunger. It satisfied my need  for a time of quiet contemplation. It gave expression for the joy that was rising up from my soul. I knew the meaning of the word, “REJOICE!”.

As an adult, I have tried to follow this soul hunger, but I have not been faithful to find a place to worship on that special night. More than ever,  I feel that I must find a place that has services on Christmas Eve so that my Christmas can come back into my heart.

In Christmas Past, when Dan and I were first together, our holidays were dictated by everyone’s schedule. After my divorce from my son’s father, my son usually left on Christmas Eve day and did not return until after New Year’s. That was very hard on me to be divorced and alone for all of the holidays. There was no reason to try to change anything. My son was 15 years old when we divorced. When he began to drive,  did what he wanted. It hurt to know that he didn’t want to be with me.

When Dan came into my life, that empty, lonely time changed. Dan had young children and I filled the void with him, his children and the crazy non custodial parenting routine.

 Dan’s children were not available until Christmas Day. Because he had children with both of his former wives,  Christmas Day consisted of him traveling in one direction and I in the opposite to pick up his children. We would drive back to our house, empty out the vehicles,  reload everything into one vehicle and we continued driving for another 2 hours to his mother’s house.

After years of this and my son’s marriage, I realized that my son and I were deprived of time together. He was in the Marine Corp and his time back home was precious. This crazy exhausting tradition was  unfair to him. I am sorry to say that I have many regrets for not seeing how            lop sided things were in regards to him when I didn’t get to see him on the Christmas holiday. I finally put my foot down and said that I was not going to drive away this holiday any longer.

Dan agreed. He had driven countless miles for visitation and holidays and it was time that we made changes. Of course, it wasn’t a popular decision with his family. We always invited them to come to us. A few times they made the effort, but most times not. Whatever concern I had in keeping the “Peace” with the in-laws faded. Too many years of misuse of Dan’s time with his children helped solidify our resolve. It was time that we protected the boundaries of our home and we made it a safe harbor for all of us by not driving 6 hours on Christmas Day.We began the tradition of picking up the children and having an afternoon dinner. This was much more enjoyable and it was more fair to my child.

As the kids grew up, having driving options and personal commitments outside of family, we again altered our tradition to accomodate everyone’s obligations. Now, they were driving the miles and the court could not dictate how the our holiday was celebrated. We began to have Christmas Eve as our time of celebration. Christmas Eve services was possible again. It was a most special service when we could attend with most all of our children. Those are the most precious memories.

After 9 pm and after having  Christmas’ with their extended families, the kids would begin coming in the door. Usually, my son stayed with Dan and Ime when he would come home from California. Even after eating a late supper, everyone was hungry or just couldn’t keep themselves away from the buffet that I would prepare. Eating and Egg Nog were in order. “Eat, Drink and be Merry…” was celebrated.

Everyone would stay up watching movies, playing cards or just “hanging out”. The house was full of laughter, music and a special memory in the making. Dan and I would finally give up and go to bed around 2 am. In the morning, everyone took their leave with a smile and a kiss. On to the next household where they were obligated. It was such a relief to not have to travel.

Those were the best years. It was a time when Dan (he was a great cook) and I would cook  for days. He helped me with the decorating of  Christmas trees and any other thing I needed done. He made everything easier for me. As in all things, we were a team. Preparing for Christmas or any holiday was great because we did all of these  things together. I miss him so as I try to put up the Christmas tree and bring out all of the things that have so many good and wonderful memories attached to them.

I miss those days when the house was full. Our hearts were full of joy. And, with the grandchildren, the memories would have only become richer. It is in remembering those Christmas’ that the pain of loss deepens.

Dan’s illness and death altered all of the former traditions. After his death last year, my son began his own tradition and he has Christmas Eve dinner at his home. He was weary of all of the “appointed rounds” and this seemed an appropriate time for a change.

His children get to open their presents in the presence of their NanNan. I don’t have to cook and his wife is a much better cook than me. She can do all of the British foods, i.e. sausage rolls, cheese sticks and Christmas trifle better than I ever did.

Yet, for me, it is an empty reminder that Dan is gone and my time of founder of the feast has gone with him.  Christmas Day is so quiet. I have no one to share it with. It is as if life and reality stands still and empty while everyone’s is full and busy.

This year, I am beginning a new tradition. I haven’t a notion as to what and how, but I am not going to continue to feel empty on that magical eve or on the following day.

I may have my own little party after my son’s dinner. Or, I may have others who normally would be alone to join me on Christmas Day. I haven’t decided.  My decision to move on without Dan must include a new tradition or I will spend the whole of the holidays missing him more.

Just another beginning in the process of new beginnings…I will still miss him. He loved Christmas.

” Merry”…”Happy”…. These words will be said to me and I to others  many times in the next few weeks…how I wish I could remember  what it felt like to be merry or happy.

I spent the holidays last year in a state of survival. I was “getting through” each day. When the holidays came, I just went  numb. I tried to not be a “drag” and I put on my best face. Those days have failed to become any kind of holiday memory. I couldn’t tell what I did on any of those “holidays”.  Maybe, I blogged about them. If I did, I need to read those entries  to know where I was and what I did because I truly do not have the faintest clue.

This year, the numbness is off  and I feel the emptiness and the loneliness more acutely than ever. Today was past “hard”. In many ways, it was unbearable.

I spent Thanksgiving with my younger sister who is afflicted with dementia. She has Down’s Syndrome and it isn’t  uncommon for people with Down’s to develop dementia should they live into their middle age years. So it is with my sister.

It seems that Dan’s death uncovered her memory loss. Even though she attended Dan’s Memorial service, she forgot about his death until this past July. When I met her at the doctor’s office, she asked about Dan and how he was. I told her that he died and, from that time to this, she has been in a state of inconsolable grief.

Her grief isn’t just for Dan. It is for all of the losses that has been in her life.  We lost our mother in 1990 and Dad in 2001. She went to live in the group home a few years before Dad died, but she never accepted the group home as her home. Now, it is more clear just how much she never acclimated.

For the past several years,  it seemed that she adjusted to living her own life at the group home rather than live a peripheral one through our parents. Life with Mom and Dad was a secure one. Her disability placed her at the center of my parent’s life. At the group home, everyone there is like her. She isn’t the “princess” and she misses the life where her wants and needs were met without having to share the lime light.

Every visit with our older sister or me, she would always thrill when we passed the sign for the city limits. A huge sigh would escape her and she would say, ” I am home.” Now, when she comes to visit the thrill has become a desperate desire and she says, ” I want to live with you.”

She reasons that Dan’s death opened space for her and  she should live with me on the family farm.  I know that I cannot take care of her and work. I can’t give to her the  dearest desire of her heart and the guilt compounds each time I see her. It makes finding joy in the midst of such unhappiness overwhelming at times.

As she tries to process Dan’s loss, she is reliving the loss of our parents as well as other losses. Our older sister has Multiple Sclerosis and, due to her health, had to sell the “home place” and the family business.

When she visits me, we turn directly in front of the house in which we grew up. Because she forgets that the house was sold, each visit causes her to relive the shock of seeing people living in her house. Each time, my eyes well up as I watch her tears roll down her face. Each time, I am reminded of that ache that comes to a heart after loss and the guilt compounds.

It is the same when she passes the location of the family business. She sees strange cars there and she insists on stopping. As I try to explain that our older sister had to sell the “plant” and that we cannot stop, she asks, “Why not?”. She wants to go inside and sit at the desk that was once hers.

She tries to hide the tears and frustration, but lately, she cannot contain her disappointment or her anger and fear.

Her bewilderment at the changes in her life only exacerbates the cloudiness of mind that dementia brings. Dan’s death, the sale of the home place and the business, each one would be hard for her to process, but now, she must try to work through these great losses as she struggles to remember the most simple things.

Where she once was independent in caring for herself and her personal needs, now she requires supervision and encouragement to stay on the smallest of tasks. As she roams from room to room, she knows that something is wrong. She shakes her head and says, ” my brain…” or she will sit on the couch and blankly stare and say, ” what’s going on?”

I didn’t take her to the family Thanksgiving dinner today. In the last few weeks,  an uncle and an aunt  were diagnosed with cancer. I knew that, during the dinner, my sister would learn of their illnesses and she would become hysterical.

When my sister hears the word cancer, she  immediately starts to cry, then sob, then wail…loudly. To her, cancer and death are synonymous. Our mother died of cancer, Dan died of cancer and so many others in our family have succumbed to this terrible disease. In my sister’s mind, Cancer=Death.

Her display of raw grief is hard to watch. Because the diagnosis for our aunt and uncle is so recent, I didn’t want my sister’s sobs to add more emotional stress on my afflicted uncle and aunt. My sister cries so hard that small capillaries will break in her face.

 All of this takes a great toll on my sister, on me, and on the staff at the group home. After the visits home, my sister’s behavior is becoming more difficult for the staff as she acts out her anger over  the uncontrollable events of her life.

Call me a coward, but I couldn’t emotionally handle the nakedness of my sister’s expression of grief. I am not strong enough to help her process the natural question of “Why?”. The depth of her losses is so much greater than mine…and I wonder how, or even if, my sister’s grief can be managed as her own ending is approaching.

Thankfully, she forgot that today was Thanksgiving and I cowardly chose to avoid the pain instead of walking through it. Instead, we ate at the local Cracker Barrel. While we were eating, I realized that she didn’t remember having dinner at this restaurant the night before with our older sister. Her short-term memory has worsened since her last visit four weeks ago.

As the holiday season descends on us, it feels like a dark cloud that must be endured rather than celebrated. I can redirect my thinking, but my sister can’t. My sister is lost in this fog and I know that her time here on this earth is ending.

I cannot remember how it  feels to be ”merry” or “happy” anymore. These days are a continuing reminder that the world as my sister and I knew it has ended….and her ending  is fast approaching .

I suppose I must discover a way to gain through loosing. It is such a confusing concept, yet it is the only way to walk out of these shadows. I just wish I knew where to begin walking through this loss. Maybe, I need to look for A Star to guide me.

Nothing signals the change from late summer to fall like the brilliant sunsets. I grew up in a house that faced the west and I became fasinated with the glories that heraled the end of day.

The autumn sunsets were always the announcement that a change was approaching. It was the ending of a season of warmth and bounty. It was the sure signal that colder weather was coming. A new and harder season was fast approaching.

One of the most striking differences from the summer sunsets and the fall was the contrast seen in the silhoutes cast by the fall sunsets. Everything before the sinking sun and its fading rays were sihouetted. The trees with their lost leaves, the barns, the houses were all dark against the intensity of the fading sun.

This has always been a bittersweet, melancholy time in my heart. I truly hated seeing the end of warm summer breezes. I waited in anticipation of the coldness of the winter snows that were sure to add more difficulty to the everyday happenings.

This year has been especially difficult for me. With each new sunset, I see Dan and I riding the motorcycle in our leathers. We would find the highest vista in the Hills of Brown County to observe the freshly harvested fields. We would catch the fading rays in the distance and know that we needed to leave before the ride back home would permiate our bones with the cold air.

I miss looking into his eyes to see my reflection. In his eyes held all unspoken but clearly known feelings reserved from his heart to mine. I miss his eyes.

Many times we would set in a coffee shop and I would just watch him watch people. He was an astute observer of people and he had a discernment into their character. He would watch them and I would watch his eyes.

I could dance in the palm of his hand with just a look from him. To him, I could do no wrong, even when he knew that I was as wrong as I could be. His eyes never betrayed me.

As I watch the fall silhouettes, the words written in his lost letter come to me.
” As I lay on the couch filling up time contemplating what is going to be, I watch you sleep. So soundly is your slumber, I wish and pray that this disease would pass and we could start all over…I miss sleeping with you and holding you in my arms. I miss the soft tender touches that passed between us. And, I miss your kisses, oh, so sweet.

I miss our bike rides in the evening sunsets. Watching your hair blow in the breeze. I miss your laughter and you wonderful smile. I miss watching our grandchildren grow up.

I feel that this disease is driving a wedge between us. I am so sorry. All I can do is pray for healing and the healing of our children’s hearts. I love you so much that my heart feels as broken as does my body.

It seems to early to stop making memories and plans. I miss you more and more…I love you as no other…

Dan

In his words, he seems to capture the silhouette of our life together. He wrote the essense of our life together and he wanted to begin again. He wanted the memories to continue. He wanted to be restored so that we could be husband and wife with all its responsibilities and wonders.

My life is so much less without him here with me and I feel my life become the shadows of the tree that lost its leaves.

His sunset has come and gone. Mine is still above the horizon. It is not as brilliant as it once was. It feels so faded and worn.

Will I ever know what it is to thrill at the changes embedded in the glories of the seasons again? I wish I knew…but where ever I am, so he will be…

I apologize for the “drought” in the writing. I began the series and then…Poof…the muse left me.

It seems the muse is more absent than present these days. It is a shame.

I don’t have the energy to revisit where I left off in the series of Changes, but the basement is where I found myself and in that moment, I came to a conclusion that I could not do this job any longer.

To fill in the blanks, I knew something wasn’t right when I picked up the medicine out of the basket. When I stopped pushing out the pills, I looked again and realized that someone had placed another clients medicines in my client’s basket.

What a mess!!! But, in spite of my weariness and my pressure to get to my next client, I did discover the error and no one received the wrong medication.

I managed to correct the error and I decided to report it to the case manager the following day. Mistake.

I was reprimanded for not reporting it immediately and I finally had enough. I knew that it was my knowledge of the medication and the diagnosis of the patient that caught someone elses error and that is the reason why I have a license.

It was the last straw for me and I wrote my resignation making it effective immediately.

Grief makes you fearless at the moment. It is afterwards that another kind of fear takes you over and you wonder just what you could have been thinking.

Nursing is the skill I possess and it is in demand. Because of the recession/depression, there are no other jobs available in this area. Our local economy is very dependent on the auto industry and everyone knows what that is right now….

In four days, I had another position. I am presently working for a home health care company that specializes in caring for children. In my earlier days of nursing, I always worked on pediatrics floors.

When I was asked why I chose pediatrics, I replied that I didn’t. Pediatrics chose me. I have always had a way with children and maybe that is because, no matter how old I become, I love to do the same things that kids do. I am just a big kid…

Even though I was hired, the manager allowed me to take a  few weeks off to deal with the  first anniversary of Dan’s death. I needed that time desparately.

For about 4 weeks, I played with my grandsons, went fishing and just enjoyed not being required to get up and get into that car and drive. My soul needed a respite.

In many ways, I am no farther down the road out of the shadows than I was when I began walking it the day that Dan died. Somehow, I believed that I would be better off financially, emotionally and physically than the moment that I was left alone in this world. I am not.

I guess I thought that I would be “changed” or morphed into someone more completed than feeling the same feelings that I did at that moment.

Many days now, I wonder just how long can I run on this hamster wheel. Always in motion, but never getting anywhere.

There are more things in my life, yet they are just a continuation of everything that was before.

I am in the basement again and I want out.

“What it would require is for me to work the extra 20 hours as well as my regularly scheduled 25.5 hours. It would require my regular clients to adjust the times that I normally arrived, but it definitely was able to be done.

By mid week, there was a problem…………………….” 

AND

“When I arrived today, the facility staff stated that the client was to be seen by her doctor tomorrow and the sore was spreading…Holy Crap on a Crutch….this day was only getting longer….and my diabetic client was still waiting. But, the bigger problem was  waiting for me in the basement….

Basements…I really do not like basements. Unless there is a tornado bearing down on me, I find  basements are usually the breeding ground for molds and spiders. Because of molds and spider, basements are not my favorite locations to find medication cabinets; but that is where this facility decided to store the client’s medications.

The cabinet was of press board with a laminate finish. It had 4 shelves;  a shelf for each of the facilities clients. There was a hasp and a Master lock on the outside for security and on each shelf was a small plastic basket that held the blister cards. Each shelf had cash box with a small pad lock. The cash boxes held narcotics.  Not a much of a sophisticated set up, but functional all the same.

Next to the cabinet was a small desk that had a low shelf under the desk top.  On top of the desk were plastic medicine cups where the facility staff would punch out the client’s meds and transport them to where the client was sitting in the upstairs TV room. A small fold out chair was in front of the desk where one could set to chart.

The lighting in the basement was a small watt light bulb; not the best. When I sat at the desk, my body would block out most of the lighting, so it was less that adequate. Just another dingy old basement that harbors mold and spiders. I didn’t feel comfortable down there. 

From the first visit, I had a gut feeling of dread about this client and this facility. As I noted in my last posting, the actual need for a nurse to come into this facility didn’t exist. I was coming into this facility to fulfill a guideline for Medicaid. As I lamented in my last posting, my entering into this facility was an inconvenience for everyone…

From the beginning, the hour that I arrived was at meal time. Not the best time, but it was when I could come.

It was the same on this day, the client was eating her supper so  I went to the basement to fill her medication box.

I didn’t learn until later  that I should have never gone down to the basement alone. The correct procedure was for the staff to go to the basement and bring the client’s basket with her meds upstairs to me and when I was finished, they returned it to the basement.

That never happened. Instead, when I arrived, the staff either handed me the keys or indicated where they were located and I proceeded to go to the basement.

On this Wednesday, I washed my hands extra long because of the potential staff infection in the home and the staff pointed to the keys that were lying on the kitchen counter. 

I went downstairs, unlocked the cabinet and took out my client’s basket from the cabinet and placed it on the lower shelf at the desk. I pulled up the chair and placed my bag at my side next to the chair.

The first blister card that I took from the basket was a new medication. As required, I wrote the name of the medication, the directions and the doctor’s name on my nurses notes. I mentally noted that this was a new doctor and it was an unfamiliar doctor to me. This wasn’t all that out of the ordinary.

Most of my clients have many doctors. They see specialists for their complicated diagnosis and having several medications ordered from differnt several doctors is not that unusual.

But, this doctor’s name caught my attention. We have several doctors from India, Korea, Pakistan etc. in this area, but it was out of the ordinary to find one who is Thai.

I recognized this name as Thai because, years ago, I worked at a Job Corp. It was the early 80’s and not long after the Vietnam War. At this Job Corp, there were many  Vietnamese, Thai and Hmong.  I became familiar with the names and could tell the nationality of the student by paying attention to the spelling of their names. Because of this past experience,  I noted that this was a  was a Thai doctor which was slightly unusual to find one practicing in the Midwest. It was just one of my musings while I prepared to dispense my client’s medications.

As I proceeded to fill my client’s med box, I continued my musings about the Thai doctor and wondered why this particular medication was ordered. It didn’t fit with any of my client’s diagnosis.

The new medication was a muscle relaxant. This muscle relaxant wasn’t the kind of med that is given for an injury, but rather, it was prescribed for someone who has spasms resulting from compressed nerves in the spinal cord or compressed fracture of the vertebrae.

I had researched this medication because I had another client on this medication, but my present client didn’t have any condition that would indicate her need for this medication. It was puzzling me.

The directions were for 3 pills 4 times a day which equalled  12 pills a day. That was a lot for an initial dose. The card that I picked up was for a 2 pm dosage. The other times, breakfast, lunch and supper, were on separate cards. This was a lot of pills.

I was tired and my focus was on getting this client’s med box done and getting on to my diabetic client. As I mindlessly punched out the pills of this new medication,  I just couldn’t get passed wondering why this doctor ordered this medication and when did my client see this doctor anyway.

As I continued punching out pills from this blister card, I couldn’t get away from my questioning this medication…something was not right…

“What it would require is for me to work the extra 20 hours as well as my regularly scheduled 25.5 hours. It would require my regular clients to adjust the times that I normally arrived, but it definitely was able to be done.

By mid week, there was a problem….”

Wednesday was one of two long days for this week. It was around 5:30 PM and it had been in the 80’s. Dan disconnected the old Roadmaster’s climate control when the air conditioner needed recharging. He did this because we didn’t have the money to recharge it so, to prevent the compressor on the air conditioner unit from running continuously, he  took it off.

This saved the compressor, but it also allowed the heat from the engine to enter the passenger compartment.  On hot days, the internal temperature inside is the heat of the engine plus whatever the temp is on the bank sign…hot!!!  By this time on a hot day, I am fatiqued and getting weary…weary and worn from the heat as well as the hours.

On this day, I was pushing myself. As I entered this client’s door, I was going on my 10th hour and I had one more client to see. I would not be getting home until after 8 PM. I needed to finish this day and go home.

As I walked through this client’s door, I had many things on my mind.

I was concerned about the switching of my usual schedule. The fact that my first client was an insulin dependent diabetic and I normally saw her in the morning, was a real concern. Today, I would be seeing her 8 hours late which made her insulin as well as her other medications 8 hours past due.   I needed to get my present visit done quickly and drive the 30 minutes from this location to her as soon as possible.

I was also processing my present client’s latest changes in her condition.

She was a relatively new client to me. I had visited her a couple of times before today. Normally, it takes about a month to get to know each client and their individual needs. It takes a month to know the client’s condition and its idiosyncrasies, which pharmacy they use for their refill medications,  but most importantly, it takes time for a trust to form between the client and their nurse. Without trust, the nurse cannot do his/her best for the client. With trust comes truth.

This particular client’s situation was a puzzle to me. She lived in a facility for the elderly mentally handicapped. Until her payment provider switched from primarily Medicare to Medicaid, her medications and all of her needs were provided by the facility in which she lived. She has lived there for years.

 Now, the waiver required her to be seen weekly by a licensed nurse and for the nurse to place her medications in a weekly med box planner. The facility staff would have to assist her all the same.

It was the guideline, but, in this situation,  it seemed so unnecessary. The medications for the clients in this  facility is a  common practice. It is similarly provided  in my sister’s group home.  All of the medications are in blister pack cards and the facility staff punches out the medicines at the prescribed times through out the day.

Because of the change in payment and to fulfill the guideline,  It required a nurse to come fill the med box. I had to punch out all of the pills for the week. Generally, most  nurses  detest blister packs. Whether they are over the counter meds or prescribed, blister packs are a royal pain. When you  punch out the pills, force can  crush the meds and some meds are not to be crushed.  Because of the way pills are compounded, many loose their effectiveness or the amount that is absorbed should they be come crushed. With blister packs and pills, crushing  cannot be helped.

 The idea behind the blister pack is one of liability. Because the guidelines prohibit untrained staff from “pouring” or administering medication, blister packs prevent tampering or handling. It is designed to go from the pharmacy directly to the client without anyone else handling the medication. This relieves the facility staff from touching the medication and they are to only assist the client with opening the medication. They are restricted from placing medication in the client’s mouth.

The proper procedure is for the facility staff  to take the blister pack card to the client, assist the client in punching out the medication  and the client is to take the medication. If you have a client with several medications, it takes a lot of time. Time that is  multiplied by the number of clients in the home. 

To save time and walking,  most facility staff punches out the client’s meds and place them in a medicine cup and deliver them to the client. Even though this compromises the purpose of the blister cards,  that is what is done. It also makes having a licensed person coming into the facility a complication for both the nurse and the facility.

 All of this processing and applying my common sense to that all of this and my conclusion that it is all redundancy just doesn’t matter. My opinion doesn’t  apply to Medicaid guidelines nor affairs of liability.  Being in this facility was a matter  of doing my job and my job  was to see to this client’s care.

I had other concerns about this client.

On Monday of this week,  I came to this facility to make a medication change that was ordered by her doctor. The medication change was directed by the results of the blood work that I drew the week before. This was going to be an every other week occurrence.

It was my intent to do my nursing visit at that time, but the pharmacy had not delivered her refilled medications as yet, so I would have to make a second visit this week thus my visit on this day.

Because I am paid per visit and I am only approved for one visit a week, I knew that I would not be paid for coming back to fill her med box. My first responsibility is to the client, and if returning later in the week is what is required, money or not, I will make the second visit for that week. For me, it is not about the money. It is about the client.

While I was there on Monday, one of the facility staff members mentioned that my client had a “sore” on her abdomen. They continued to tell me that one of the facility staff had been off work because there was MRSA in the home.

My ears perked up. Medicine  resistant bacterial infections scare me. I have had my own personal experience  involving streptococcus which resulted in a cellulitis. Because of my long list of allergies to antibiotics,  I was hospitalized for  4 days. Because of this past experience, this development with my client personal concern and caution. In light of my own risk, I suggested that the facility staff make a doctor’s appointment for the client.

My mind was whirling.  No one reported this infectious condition being in the home.  I don’t like walking blindly into this kind of situation. Even though I practice safety precautions and wash my hands innumerable times a day, I know that this kind of infectious disease is a danger to me and to my other clients.

I couldn’t understand why the Case Manager didn’t tell me about  this after she took the admission information from the intake visit of this client. Maybe, she was not aware of the infectious condition inside this facility.

So,  I called her and reported the condition. She stated that nothing was said at the time of the intake interview and she agreed that the client should be seen by her physician and for me to not expose myself to this possible infection.

When I arrived today, the facility staff stated that the client was to be seen by her doctor tomorrow and the sore was spreading…Holy Crap on a Crutch….this day was only getting longer….and my diabetic client was still waiting.

But, the bigger problem was  waiting for me in the basement….

As some may noticed, I haven’t been posting as frequently as I did in the past…there are several reasons.

At first, it seemed that what was in my heart was already written. I have found that grief can be a continuous “loop” of emotions and images in my mind. There have been days when I wished that I could hit the “Stop” button and take a rest from my tumultous feelings and intrusive thoughts of Dan’s death.

But, unfortunately, there is no such button and the continuous play of these ever present memories wear me down both physically and emotionally.

Weariness is a thief to the body, mind and soul.

I didn’t post as much because I felt that writing and re writing thoughts and feelings that I had expressed here was a redundancy that no one should be subjected to, not even me.

Also, in the past few months, this old computer has made quite a few unnerving sounds that only supports my fear that it is about to take a major and expected full stop. It  is getting “old and moldy”. I have spent many hours at this keyboard that  resulted  in loosing all that I wrote. It has become a frequent occurrence.

When this happens, I don’t know whether it is a part of grief or my natural “red head” reaction to frustration because my next thought is to take a hammer to this churning box of circuits and make a permanent “adjustment” in its motherboard. Thank goodness reason returns  and I count the cost…close to a thousand dollars to replace it…and I don’t have the money for that, so I put the hammer down and start over.

Much of my lack of posting  has its base in my ”technical difficulties”….there are other reasons….

As the months and weeks approached in marking Dan’s death, a restlessness began to “boil” inside of me. I talked with my grief counselor and found that everyone has different reactions when this milestone is reached. Some become more emotional; I, on the other hand, became more anxious which results in a lack of patience and a relentless need to keep moving.

She asked how things were going at work. I replied that I had a few frustrations and I told her about  things that had happened that was leading to my discontent. The majority of my differences are with personalities. I assured her that it was  nothing that I couldn’t handle and I expected some of this kind of frustration as I have employed people when I owned my own companies. I find that I do not enjoy working with an all female staff…I prefer working with men… male clients, male coworker…I am not the sorority sister type.

I also told my counselor that I had a “knowing” that I would not be with this company for much longer. As I explained this intuition, I demonstrated what I was feeling about my job by placing my hand to the outer perimeter of my peripheral vision to show that I knew that a change in employment was coming soon. I also said that I felt that it would be better for me, yet I was relunctant to make any change because of not wanting to leave my clients.

I explained that, in April,  I had been offered a position with an Indianapolis based company who provided home care for children and that, even with the offer of more money, I decided to stay with my present employer. I continued to explain that I believed that my clients gave more to me than I could ever give to them. My loyalties lie with my clinets over any loyalty with the present company.

Yet, in my heart of hearts, I realized that I just could not face changing anything as the first anniversary of Dan’s death loomed before me. I suspected that my decision to stay rather than accept the new position was one that was rooted in grief and anxiety.

Little did I know just how accurate this forknowledge would be.

In late May, I talked with the scheduler and requested that I have Tuesdays  and Thursdays off. I told the her that I knew that they were having trouble replacing the 22 hours that were lost when one of my client’s grandmother became disgruntled with the company and changed agencies as provider for her granddaughter’s care. The issue that prompted the change wasn’t one of quality of care, but rather, an issue over how her hours were administered by this company.

Since April 1st,  the company tried to replace these lost hours, but 22 hours is a lot to replace in a short time. One of my goals was fast becoming unattainable. I wanted benefits i.e. paid vacation time and medical insurance.

I stated that it was clear that I was not going to qualify for these benefits before my anniversary date and that with having only 25.5 hours/ week, I felt that  I didn’t need to go out on a daily basis. I knew that I could work those hours  in three days and that would help with the wear and tear on my car,on me and was more cost efficient for me.

 After some discussion, she agreed to my having one day a week off rather than two that I requested. The schedule was modified for me having Tuesdays off.

I also discussed with the scheduler that even without paid vacation time, I wanted the week of Dan’s death scheduled off. I explained that I needed the time because I didn’t know how I was going to emotionally process this anniversary.

I was concerned about the financial impact of loosing the weeks hours, but emotionally, I really didn’t care. I would find a way to meet my obligations, even if I didn’t eat…it would not be the first time that I had to do without something. Time is what I needed…more than anything.

It is just another example of how so many health care workers are denied health care coverage and benefits because many home health care companies refuse to guarantee hours to the field staff.

Never mind, that is another post….

Two weeks before the unpaid vacation, an opportunity came that would allow me to pick up 20 extra hours. That would pay for my week off and I accepted the extra hours gratefully.

What it would require is for me to work the extra 20 hours as well as my regularly scheduled 25.5 hours. It would require my regular clients to adjust the times that I normally arrived, but it definitely was able to be done.

By mid week, there was a problem….

It has been a year since I heard the sound of your voice, felt the soft caress of your hands or watched your sly smile and that mischievous glint in your green eyes.

It has been a year since I have felt your warm embrace and felt safely encircled by your strength.

It has been a year since I was able to touch your face and to tell you how much I love you. To reassure you and myself  that we were a team and we could face any adventure together.

It has been a year that I have been alone with my thoughts. Thoughts  filled with tortured memories of your last moments, of  the tears that you cried when you knew that you were leaving me for the final time.

It has been a year since I have felt complete and whole.

As I face this anniversary, I understand, for me, that there will be no relief from this terrible loss of you and of myself.   I realize that I may never heal from cancer’s cruel tearing us from one into two. The wound is still so fresh and it has torn my heart so deeply.

You were the best part of me and I feel that I lost my way when you could no longer walk by my side. I am so much less by your leaving…

How many years will I walk in the shadows of this time?  A lifetime of brokeness seems as long as eternity itself….

But, until, I can see your face again, Until that moment when I translate from this form of existence into the next, may God watch between you and me until we meet again..

Until then, my love, until then….

When I spoke those words to Dan, we were in the beginning days of our second chance at love…

 He had just said that he wanted to date other women. The truth of the matter, I knew that he had never stopped seeing others besides me so this wasn’t a real surprise.

I knew that I couldn’t react to his statement, yet I knew that  I needed to establish that I was not going to be undone if he didn’t want a life with me.

At that time in my life, I had survived a messy divorce and I was determined to never “need” a man.  I owned a company and I was providing for my son and myself quite well.

What I wanted was to share and build a life with someone and I knew that I wanted Dan to be that person. 

I also  knew that  Dan had been emotionally devastated by his last marriage and divorce. I held on to the belief that somewhere inside this wounded man was the one that I had loved when I was 17 years old.

Had I reacted like Dan expected me to such a statement, I knew that he would have run like a deer on the first day of hunting season. So, uncharacteristically,  I managed to appear a little  “nonchalant” about the whole idea of him seeing other women, all the while, my heart was about to wilt.

Swhirling around in the middle of the tornadic statement, I knew that he cared for me, even loved me, but I also knew that I represented everything that he believed to be a total impossibility for him.

I represented stability, normalcy, even a safe harbor. All these things were the deep desires of his heart but he convinced himself that he destroyed them. He fearedthat he would either disappoint or fail me.  He was well aware that he had a pattern of walking away and leaving those he loved behind.  

He had endured much emotional abuse and suffering from his second marriage. His heart was left with a huge hole filled with bitterness and, at some point, he vowed that he would hurt as many woman as he could ( his CB handle was Heartbreak) because of how one woman hurt him….I knew that he was tottering on the brink of hatred for women, but I believe that he knew that he cared too much for me and that he didn’t want to do that to me.

As a heavy silence hung in the air immediately after he made his statement, I finally replied  that it was alright if he wanted to see other women, but if I found someone that I was interested in, I didn’t want to see him. 

His reaction was one of being off balance at both my reaction and my statement.  He hadn’t anticipated my response.

He asked that, even if we dated others, if he couldn’t come by my place for a glass of ice tea from time to time. I replied, “No.”

I told him that if he needed to talk to me, he knew where I worked and he could talk to me there. I went on to say that, if I was involved with someone else, I didn’t want to know anything about him, his family or any thing that we shared together, so, in essence, there was nothing to talk about with me.

He commented that when I ” cut it off ” I cut it to the bone. That is when I made this statement, ” I had a life before you came back and I will have one after you leave.”

With Dan, I would have been lying to myself to believe that I could be “just friends”    I love too deeply to try and pretend that what I felt was only friendship. My heart never heals when I try and lie to myself about my feelings.

 I realized that if things didn’t work out for us, I would have to go on and  never look back. With my response to his statement,  I wanted to convey that the time for us was now and that there would not be a “third time is the charm” opportunity. After a few days,  he decided that he wasn’t that interested in seeing other women. Maybe my response was THE defining moment that secured our future together and it led to our marriage.

The other day as I was driving to my next client’s, I recalled my statement. As I pondered what I said to him at that time,  it hit me. I realized that I was beginning to live my “after life”.  

To have my “after life”  I am having to recall all of the pieces of who I am. Some of those shattered shards will be discarded and others that were made during our years together will be carried forward with me.

Daily, I am rediscovering pieces of myself that I thought were lost; and others are new and exciting. All because there was a before, during and after lives. All of this brokeness complete with its splintering is producing a new definition of myself. It is so much differnt life that I had with Dan and so unfamiliar with the one that I knew.

A year ago, I could have  never fathomed my life  without Dan in it. Now, it is quickly approaching my horizon. In two weeks, it will be one year of life after Dan’s death.

Somehow, those words that were spoken are coming to fruition and I marvel that they were so prophetic….

I could have never dreamed when we first started our lives together that I would be living without him in a short 15 years. It makes me sad to think about those words today and how they became true.

Yes, there is a life without Dan. If taking those words back could have prevented them from coming true, I would do it in a heartbeat, but that isn’t reality. It is just one of those grief moments when the life I am living seems that it should belong to someone else.