A Five Year Journey…Walking out of the Shadows

It has been 5 years since Dan died. They have been difficult spiritually, emotionally and physically, but they have been lived. I have been walking out of these shadows.I didn’t know if I would at first, but, in my pain, I did make strides, small steps and large leaps.

For the first year, it was pure survival. I didn’t make memories. If I did, I don’t remember much. I do remember loosing my keys at my doctor’s office and he took me home to get my second set. While here, he took out my air conditioner.

I remember crying while I drove between my home health patients. I continued to pray that the “forgetfulness” would not be the cause of making errors….

I learned that this kind of distraction was normal for those who are in the “bowels of grief”. It was such a comfort because I began to think that I was loosing what was left of my mind.

I lost; a lot that first year. I lost a lawn mower. That was difficult because I have over 2 acres that had to be mowed. It took over 2 years for a solution to the grass mowing saga to be remedied.

I lost my computers to a lightening strike to the house. It hurt the new TV that I purchased because the old Sony bit the dust. I didn’t have a way to replace my computers and connectivity until a friend gave me her old laptop and I paid a cousin to get it to boot up. Now, it is in my work office and I use it every day. I  recently purchased this new Toshiba…I am amazed at the advances that were made in these machines and the Net during the years that I wasn’t online.

My greatest lost was this blog. I tried several time to write but the pain of loss seemed to dry the words that were so bountiful as I walked with Dan to his sunset. I missed the people who were my support during this time. When I finally was able to get online with my smartphone, I couldn’t afford to write because of the inconvience of the smaller screen and the cost of usage.

Many times I longed to write, but I didn’t know where to begin to write about the changes or the new losses…my sister’s dementia, my older sister’s MS…the 7 funerals in 4 months…how can you write about what has become a new thread in the fabric of living?

Just like the elephant, you eat it one bite at a time and just like now, if I choose to write, it is one word at a time.

The losses were not the only occurrences. After; the losses of a car, Dan’s truck and many other worn out equipment, new replacements were obtained. Some in the usual manner of purchases, many by extraordinary circumstances. I know that what was done on my behalf was not by chance, but rather by divine providence….

The most astounding providence was in the new people who entered my life. One family in particular actually helped me come out of the natural mourning process and I did choose to live.

I wish I could say that I am pleased with the progress. I know that there is much more to accomplish in this journey out of the Shadows, but now, I am grateful for this new laptop, a new car, a new job and most of all, the knowledge that I did not take one step alone.

My steps are ordered by the Lord…no doubt…

Advertisements

Sunset in the Valley of the Shadowlands

I made a decision. It is one that I have pondered for quite a while.

Now, it is time.

Over the past few months, I noticed that most of my last few blogs have been the same. They are pain, more pain and endless pain. That is the way it is after the death of a loved one. Each day is the same, just different circumstances.

It will be 2 years in July since the sunset of Dan’s death. Counting the months and years doesn’t make it easier. It is a reminder that one life ended and yours goes on and on and on.

I must say that I have a “normalcy” of sorts. It isn’t the life that I enjoy, but it is my life. I have made decisions of my life based on what I learned from Dan’s life and death. I have things that I want to do before it is my time to leave this earth.

I also know that I have no regrets in the choices that Dan and I made. We made wonderful memories instead of waiting until “retirement”. I can say that we lived and we lived in love. Music was our language and we made beautiful music together.

Dan left me with a glimpse into my future. He said that he must leave so that I would fulfil my destiny. As to what that destiny is, I still do not have a clue. But, this I know, I will discover exactly what that destiny is and I will complete it as my life’s work.

As for my blog. It has served its purpose and it has been a part of my destiny. It was the vehicle that carried me over the highest hurdle that I ever had to live.

Each one of you who read and followed the darkest days of my life became pillars that held the sky over my head instead of it crashing all around me. I made many “sight unseen” friends. You are as close to my heart as any who I knew in the flesh.

I owe a great debt to each one who commented and emailed your support and empathy. There are no words to tell you just how much of a blessing you are to my aching heart.

The days ahead will be full of life for me. I shall live and I am hoping that it will be a full life. One of love and purpose.

I have been toying with the idea of going to college and obtaining a degree in social work. I already work with children that bear the emotional wounds of mental and physical abuse. I would like to be a part of prevention rather than just binding the wounds.

The effects of death leave relationships and their destruction in its wake. I have lost friends and blood relatives to the aftermath of loss. It pains me to understand that it a part of death and dying. It is an unnecessary part of it, but it is a part all the same.

Rebuilding a single life after living it as a pair is one of the most challenging part of this life after the sunset of death. It is a life that is built one day at a time. Re entering life after being surrounded by cancer is difficult. Cancer has changed your life as much as it has stolen the life of your loved one.

There is only one choice in all of this whirlwind. You must choose to live in the present or live and die the rest of you life in what was.

I aways chose to live. I didn’t know how to do that, but each day, I find that I continually choose life.

That is the key to climbing out of the shadows of the Valley of Death.

Scripture says that we are to choose life or death every day. I choose life and to have life more abundantly more than it was when Dan was here with me. I don’t know where the path of life will take me, but I will live and I will find purpose in each day.

I have another challenge as I choose to live. My sister with Down’s Syndrome has dementia.

She has had an emotional break down because staff and clients have taunted and teased her. They thought is was funny to do things that made her angry. Two weeks ago, she lost all control and became enraged to the point that she began hitting, kicking and biting staff.

I went to the group home and picked her up and took her home with me. As sunset approached, her anxiety intensified and she became enraged with me. She physically attacked me and I had to physically restrain her so she would stop hurting herself and me.

I searched for medical and psychological help. No one would help us because she was Down’s Syndrome and they said that she was ” INAPPROPRIATE” for their programs. I had no help and no hope until someone in the ER kept on calling until she found someone at the State level who would come to my home and evaluate my sister.

Those were the longest 80 hours of my life. They were as difficult, if not more so, than the final days of Dan’s life. Fortunately, the group home has eliminated the staff that allowed other clients to torment my sister. The group home realized that they were unprepared to handle the situation that my sister’s condition presents and they are willing to educate themselves and the staff as to how to best care for her.

In my desperation, I found organizations for adult Down’s Syndrome people who have dementia and these wonderful people are willing to come and advise all of us as to how to care for the behaviors that my sister is presenting.

Now, my path is to help my sister face her final days walking on this earth. I will help her face her fears and comfort her as the sunset approaches her horizon.

It feels like repeating Dan’s final days with my little sister, but because of Dan, I know better how to help her walk toward the day of sunset.

So, it is my decision to leave my beloved blog behind and begin anew. I will be writing a new blog for those who must walk the Valley of Death with those who are more challenged to understand the spiritual concept of NEW BIRTH through death.

It is my hope that others will not have to repeat my days of darkness when I searched for hope and help with my sister.

So, I am saying a loving, “Fair Thee Well” to all who met me here. I love all of you who gave me strength and courage. I will pay it forward to those as you gave it to me…

I will leave you the words of the song that I sang to Dan as he died:

If You must go….

Then go in Peace

Go in His Strength, where’ re He leads.

Know that you take the Bread that’s been broken

Walk unafraid, humble and free.

Know that you are not alone, Know that you are not alone.

Had it not been for sacrifice

Nothing could quench this thirst for life

Never forsake the One that’s been given

Keep His dear cross ever in sight

He has made you His own. He has made You his own

God be with you, May He shed His Grace

On your darkest hours and your best of days

Nothing below or above can come between you and His love

Remember you Go in the Shadow of the Cross

Valentine’s Day Without a Valentine

Growing up, I don’t remember Valentine’s Day being such a big deal…that is until Dan came along.

My parents didn’t do much for each other. I don’t remember flowers or candy coming home with my dad. There certainly was not anything for my sister or me. The only thing that I remember was picking out those paper Valentine’s cards with Mickey Mouse or Goofy and deciding which one of my classmates was going to get the pretty one and who was going to receive the “Goofy” card.

The most memorable Valentine’s for me was my 16th year. Dan and I had a couple “dates” (if anyone would classify them as one.) I saw him everyday at my father’s company. But, I do remember waiting to see if Dan would ask me out on a “real” date for Valentine’s. I waited at work and then I waited by the phone. Nothing. Nada.

Valentine’s Day was on a Saturday that year. As usual, I was home. There were not many,  but, for a few moments, I wasn’t thinking about Dan or the old boyfriend or the other couple of guys who I knew wanted to ask me out. I can’t remember what had taken my attention away from it being Valentine’s Day.

The door bell rang. My mother went to the door and she returned with something in the green paper that is used at the florist’s.

I was surprised when she said that this was for me. I opened the green tissue paper. There was a single rose in a vase. I took a deep breath to inhale the scent of the beautiful rose. It was lovely. Then I opened the card. It was from my old boyfriend. I put the vase down with the card and went to my bedroom.

My mother came to the door and asked if I was alright. I told her I was just fine. She knew that I was disappointed that it wasn’t from who I wanted it to be.

It was still exciting. That was the first time I ever received dlivered flowers and they were  from a boy.

A couple of hours later, the door bell rang again. I looked out of the window and it was the florist’s van. I ran to the door. This time he had two green wrapped offerings. I thanked him. He looked so tired. I imagined that he was tired of driving so far out-of-town. He combined these two deliveries to save time and gas.

I opened the first one. It held a beautiful bowl and pitcher with a rose with ivy. It was from a fellow that had wanted to date me but he was much older and my father frowned on the idea. I like him, but I liked his GTO better. He was persistent. I sat the bowl and pitcher down on the dining room table. My mother said it began to look like a florist’s work space.

I opened the last one. By this time, I thought that Dan had not been as interested in me as I was in him. I was not expecting this one to be from him. Much to my surprise, it was. There were six red carnations in a vase. I was thrilled. My mother looked at me and said, “This is the one you were waiting on, isn’t it.” She looked at the card. She didn’t smile. She didn’t approve of Dan.

That was the first Valentine’s Day for me. I understood more of why everyone made a big deal of it. I felt wonderful yet, I wondered who Dan sent the roses to. It wasn’t me. And, I didn’t get a phone call or a date. I knew that I was an “honorable mention” in the long line of girls that Dan saw. I didn’t like it much, but I knew that it was the way he was. I still hoped that he would “come to his senses”. Twenty five years later, he did.

Dan always remembered Valentine’s Day. There was always a beautiful card with a hand written note on the inside. At the end of the hand written note, there was a ” P.S.  I love you.”

On our last Valentine’s Day, he couldn’t get to the store and he was worrying about how to get me something. I told him that I didn’t need anything but being with him. I reminded him that I would have much rather had a date with him than 6 carnations on our first Valentine’s Day. He would always sheepishly smile. I knew that he didn’t spend that night alone.

To celebrate Valentine”s Day,  I cooked a special meal and we had candle light. At then end of the dinner, he brought me an envelope. In it he wrote, ” My love for you is a never-ending river. I love you like no other. ” I cried, he cried and we spent the evening holding each other like two frightened children in a terrible storm.  It was the most special Valentine’s Day of my life. It is  THE one that I will hold onto for the rest of my life.

In the years before cancer, Dan would always had a card for me and a present. When it came time for me to buy Dan’s Valentine’s Day present, it was always lingerie for me. Dan appreciated his gift. There is something about the look of gratitude in a man’s eyes when he sees new lingerie by candle light.

Because of those wonderful memories, I have been avoiding everything Valentines. Commercials are ever-present. Stores are full of hearts and red flowers. All of this is too much for me. I am surrounded by things that remind me that I am alone, of Dan, of those wonderful past Valentines…and it hurts. It hurts alot.

It seems to increase my desire to have someone in my life. A special someone or someone who finds me special. Maybe, that is what I truly want. someone who finds me special.

The other day, I sat in the doctor’s office waiting for my named to be called. I sat besides an older lady. She definitely was in her 70’s. She began to chat away. Very early in our conversation, she told me that she was waiting for a gentleman who was being seen by our doctor.

She spoke his name as if I should recognize it. I didn’t and then she went on to tell me that he was in real estate and, with great pride in her voice, she said, “We’re dating”.

The sparkle in her eyes and the enthusiasm in her voice reminded me of  a teen age girl bubbling over her first boyfriend.. It was clear, she was reliving her years when boyfriends were kings and being the girlfriend of the high school quarterback made you somebody.

I smiled. I noticed her hair was perfectly quaffed, she had spent hours for her to put on her eye  and she was very smartly dressed. She had gone all out for this doctor’s appointment. As her boyfriend appeared from his time with the doctor, her eyes lit up and all she saw or heard was him.

She had no illusions that this guy was “The One”. She already lived a life with the love of her life. This man was her special friend, her hero. He had rescued her from endless lonely days. This man had saved her from living the life I am living.

It was sweet. For a brief moment, I was jealous.

She found a different kind of love. She found a love of acceptance. Acceptance of her wrinkles, of her gray hair, of her extra pounds and of her less than firm body. She found magic.

She was showing me that it was possible to find great friendship and companionship no matter what everyone says. In the midst of all of her chatter, she was telling me that it is possible, no matter how unlikely, to have a “Happy Valentine’s Day” again…

Lamentation

My God

You have not forsaken me, but I have lost my way to Your Heart.

My soul has lost its refreshing dew and I thirst for Your Love and how I once knew it.

My body is weary and worn. It cries out daily for renewal and refreshment. My bones ache with the weight of sorrow and my despair only deepens.

My heart is shattered as a pane of glass. It is scattered by the winds of loss. My emptiness consumes like a moonless night.

“How long, oh Lord, how long?” is the echo of my lamentation. Hourly, the losses in my life mount higher. It seems as if they are as tall as the highest peak and as deep as a  fathomless ocean

I seem to labor to keep body and spirit together yet, I find no harvest…no reward. It is an internal battle that has a fierceness that desires to destroy me.

Relief is my physical cry. Refreshment, my soul’s plea.

I know that my heart’s lament is not lost in a sea of deafness. I know that my name is on Your lips. My life is seen by Your all-knowing Eyes.

It is my heart, oh Lord, that is shrivelling within my breast.

I cannot save myself.

It is You, my God, the Lover of my soul, it is to You whom I cry.

I surrender my life, my self , my all to You and Your will.

I shall be restored to Your Master Plan.

I shall look on my life and rejoice for I have seen Your abundant Grace, Your Unmerited Favor on my life in this land called Living.

I shall stand.

I shall stand on Your solid Rock.

It is the Rock called Hope.

Christmas Eve 2009

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!!!

The Basement

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.

Changes…Part III

“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.Lost in the Storm

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…

 

Changes… Part II

 

“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.Lost in the Storm

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….

Changes….Part I

A Work of ArtAs 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….

AmazingAs 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.Lost in the Storm

By mid week, there was a problem….

” I Had A Life Before You Came And I Will Have One After You Leave”

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.