Category Archives: home

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Arrive and engage

Home again! I came home from Grand Junction, Colorado via Denver. Wrong direction and an additional 440 miles, more or less. I spent two nights at my daughter’s home and she and her boyfriend took me to the Botanic Gardens and to a birthday high tea at the fabulous Brown Palace Hotel. I guessed it was built in 1880. Close: 1892. We had tea in the atrium with ten or more stories above us, balconies all around and stained glass at the top. Quite gorgeous.

From Denver, I drove north and then northwest, Colorado, Wyoming, Idaho, Oregon and Washington. The pass in Wyoming had sleet and slush, terrible visibility and ice on the road. The speed limit was 35 and everyone ignored it. That was my second day and over 400 miles and both the cat and I were very glad to arrive at the hotel. Sol Duc complained quite a lot the first day and then settled down.

Driving into Oregon over another pass, suddenly it is green. Shades of brown before that but once over the pass, bright startling green. In Washington, Snoqualmie Pass brings the smell of the Salish Sea and we are close to home! We left Denver on Monday and arrive in Port Townsend on Thursday afternoon, delighted to get out of the car.

And hooray for being home! It was a little disorienting after being gone for most of eleven months. I miss Elwha cat and I think Sol Duc wondered if he was in the house too. A friend came over and brought some staples and another friend dropped off my first CSA farm box, from Wednesday! How wonderful!

On Friday I went to walk with another friend downtown, while her husband and daughter went scuba diving. The alpacas were downtown, being socialized and wading in the sound. They have very expressive ears and clearly the sound tasted peculiar. They were all well behaved and so were we.

Home, arrived and engaged already, alpacas, friends and demonstrations against P47’s insanity.

For the Ragtag Daily Prompt: arrive and engage.

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What to check before bringing your elder home from the hospital

I get a call from the hospital (this is over a year ago). They say, “Your friend is ready for discharge. What time can you pick her up?”

I reply, “Can she walk?”

“What?”

“She has three steps up into her house. Can she walk, because otherwise I can’t get her into her home.”

“Oh, uh, we will check.”

They call me back. “She can’t walk. She’ll have to stay another day.”

I knew that she couldn’t walk before they called. She could barely walk before the surgery and after anesthesia, surgery and a night in the hospital, her walking was worse. She had been falling 1-5 times at home and the surgeon knew that. He did not take it into account. The staff would have delivered her to my car in a wheelchair and then it would have been my problem.

She was confused by that afternoon, which is not uncommon in older people after anesthesia. She stayed in the hospital for six days and then went to rehab, because she still couldn’t walk safely.

Recently I have a patient, an elder, that I send to the emergency room for possible admission. He is admitted and discharged after two and a half days. Unfortunately he can barely walk and his wife is sick as well. The medicare rules say that he needs 72 hours in the hospital before he qualifies for rehab. We scramble in clinic to get them Home Health services, with a nurse check and physical therapy and occupational therapy, and I ask for Meals on Wheels. It turns out that Meals on Wheels will be able to deliver in two months.

The wife refuses to go to the emergency room. I tell her that if she does get sicker, that they both need to check in. The husband can barely walk and is not safe home alone. If one gets hospitalized, they both need it.

If you have a frail elder, be careful when you are called about discharge. Go look at them yourself, make sure that you see that they can get out of bed, get to the bathroom, walk up and down the hall. Can they eat? Do you have steps into your house or theirs and can they go up the steps? I got away with saying please check that my friend could walk because I am a physician, because I knew she couldn’t and because there was no one else to pick her up. Do NOT ask your elder. They may want nothing more than to go home and they may well exaggerate what they can do or be firmly in denial. You want them to be safe at home, to not fall, to not break a hip and to not be bedridden.

For an already frail elder, even two and a half days in bed contributes to weakness. And being sick makes them weaker. If they are barely walking when they are admitted, it may be worse even after just 2-3 days. I used to write for physical therapy evaluation and exercise when elder patients were admitted, to help them for discharge. Once I got a polite query from physical therapy saying, “This patient is on a ventilator. Do you still want a consult?” I reply, “Yes, please do passive range of motion, thank you!”

Your elder does not have to be doing rumbustious dancing before they go home, but they need to be able to manage stairs, manage the bathroom, manage walking so that they can get stronger. Otherwise a stay in a nursing home or rehabilitation facility may be much safer for everyone.

For the Ragtag Daily Prompt: rumbustious.


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Thinking about this and that

I am thinking about thinking. What do people think about most of the time?

This partly comes from my ex. He thinks out loud a lot, an external processor. My daughter and I wanted to know what he thinks about. My son asked. “Dad, what do you think about?”

“Golf.”

“Golf?”

“Yes.”

“Anything else?” says my son.

“No.” says my ex.

I have no idea if this is true or not. Sounds hella boring to me, honestly, but he seems entirely happy with it. De gustibus non est desputandem.

I had lovely winter holidays, celebrating EVERYTHING. I went to my son and daughter-in-law’s out east. My daughter and her significant other came out and we did presents on December 27th. Then we went to see my two aunts and uncle for a couple days. They are in their 80s and delightful! Back to my son’s and we saw my kids’ remaining grandparent, my ex-husband’s father’s significant other. Got that? And one of my kids’ paternal cousins with her significant other. I stayed with old friends for the last three days, which was also delightful. We went to the Smithsonian American History Museum and read every single thing. But only in two exhibits because that place is huge.

Now I am back to my current home and hello, cat! Back at work as well. More about that next time. The sands are shifting and I may be in another clinic. Monday a patient asked if I am their new doctor or am I a floater? I said I prefer “Temp” to “Floater”. She laughed.

For the Ragtag Daily Prompt: think.

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All home

My daughter and her significant other arrive two nights ago and we open packages and stockings yesterday morning. Lots of laughter and chocolate and much contentment. Now I have a climbing harness in pale green! We did not climb yesterday, I was too tired. We did go for a park walk on an old golf course and had a delicious dinner. It is lovely to all be gathered here and trading stories and jokes and family silliness.

Today I am up early. We will drive down to see my two aunts and my uncle. The great aunts and uncle to the kids. A very delight!

For the Ragtag Daily Prompt: contentment.

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Today and tomorrow and the day after

Good morning! I hope you are having a happy day today! I am up and having tea and reading and listening to music, waiting for the rest of the household. They may be a while.

I arrived at my son and daughter in law’s on Sunday. The glitch was that my son and I couldn’t find each other in the pick up area and got frustrated. Turns out that I was at National Airport and he was at Dulles, which does make it more of a challenge. I took my bags and hopped the metro out into Maryland, and they picked me up at the station. Whew.

We are talking, eating, wrapping things and climbing. We went to their climbing gym yesterday and I did a respectable job on some 5.6 and 5.7 climbs. Today my arms want to fall off. Last year my climbing style was panicked sloth. This year I am much better since I have been going to my climbing gym once a week. Arm muscles! How amazing!

We are going to continue wrapping today. My daughter and her boyfriend arrive late tomorrow so we aren’t going to tear paper off stuff until Friday morning. My inner little kid suggests that we unwrap today, wrap it back up, and do it AGAIN on Friday. This waiting frustrates her! Oh, well. No, dear, we aren’t going to do that.

Have a lovely today and tomorrow and day after tomorrow!

For the Ragtag Daily Prompt: today!

The photograph is Elwha looking up at the Christmas stick last year. I miss him!

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Cliff collapse

This is taken on Marrowstone Island, going south from East Beach. The king tides take down sections of cliff and whole trees every years.

The island surfaces in the low tides and the seals rest and sun and ignore the ships.

For the Ragtag Daily Prompt: collapse.

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Chew on this

No, hummingbirds don’t chew as far as I know, but they sure are tough. I had an Anna’s hummingbird that would overwinter in Port Townsend, surviving even when it was snowing and got down to 17 degrees. The food would freeze and I would have this small fierce creature swooping over my head making a ticking sound to remind me to thaw the food out.

My daughter and friend started over the mountains last night but holed up in a motel partway. They said that the roads weren’t that awful but the lack of visibility was exhausting. It is hard to see where the road is in the teeth of the storm! I am glad they are safe and we will see what happens today!

I learned to take the food in at night, so it would be all ready in the morning.

For the Ragtag Daily Prompt: chew. (Choo choo! I wonder if the train is getting through!)

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Tool

I don’t wear livery at work
and anyhow that’s a uniform for men
or a place to board horses
though the horses can be male or female.
Once I go to my daughter’s second grade
for a bring your parent day
and bring part of my uniform,
or perhaps it is a tool or instrument,
my stethoscope. The children all want
to listen to my heart
or at least touch this magical tool.
Afterwards I receive thank you notes.
I think that every one, except my daughter’s
thanks me for bringing the stethoscope
to their classroom. I did not know how
special and magical a tool can be.

__________________

For the Ragtag Daily Prompt: livery.

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Made it!

Sol Duc and I made it home on Thursday, 325 more miles, arriving happily to the house in Grand Junction. I got ready to take her for a walk later and stepped outside: snow! We went over 7 passes driving from Port Townsend to Grand Junction and some smaller peaks that did not have the altitude marked, but didn’t get snow. On the last night a big storm was rolling in from the south east in Colorado and from the west in Utah. I thought, whew, I may just make it.

We did and I took the photograph yesterday morning before driving to work. Just a sprinkling, more as I got to Palisade, but not on the roads. It warmed up and melted through the day.

People have told me that Grand Junction does not get that much snow. That may be relative, that it might not be much compared to Denver, but a lot more than Port Townsend. I have no clue! We will see.

For the Ragtag Daily Prompt: unexpected and no clue!