The Oppenheimer Report 8/26/13

To add to the joy which has been this summer, we have had flooding in the basement of the family home in Toronto. The heavy rains in early July made their way into the house, and when Shauna and I began to investigate it became apparent that this had been a problem for a long time. The finished basement was full of junk, so the moisture problem was not immediately apparent, but when we started to move stuff around, it was obvious that this was a serious problem. When we discovered mold had formed all around the base of the walls we decided that it was time to get the insurance company involved. This all happened about the time Dad Taylor had stroke #2 in December. At that time it become abundantly clear that house maintenance had not been a priority for Mom and Dad Taylor in quite some time.

The mold remediation guys came in and did their thing, and in the meantime we gave away three refrigerator boxes full of old clothes that were piled up in the basement. One of our caregivers sent them down to a charity in the Philippines coordinated by one of her family members. Some of the other stuff was ruined and ended up in the dump, and the rest, which included most of the personal property of Shauna’s brother, who had died in 2000, ended up piled up floor to ceiling in the laundry room. When Shauna and I arrived in early July (I had been down in June for stroke #3), all the drywall and paneling was stripped and removed, electrical wires were dangling from the ceiling, the floor tiles and sub floor in one room had been torn up and removed. In short, the basement was a somewhat organized disaster.

Now that the toxic mold had been removed, and much of the water damaged debris removed, the next step was to ensure no more water seeped in through the foundation. After several bids we settled on a waterproofing company called Mud Monkeys to do the waterproofing, based largely on customer satisfaction reviews we’d read. So far, so good, but this is major construction work, which involves digging 5-6 feet down to the footings of the house foundation, installing proper weeping tiles (the original clay weeping tiles, designed to divert water away from the house had for the most part cracked or disintegrated, and were in any event woefully inadequate to handle the drainage for this house), filling gaps and cracks in the block work, sealing the blocks with concrete, covering that seal with tar and heavy duty polymer wrap, then back filling. It is slow, noisy work and I am sure our neighbors hate us by now. I hate us. Every morning at 8am the jack hammers and augers begin to pound out their cacophonous symphony, and we awaken un-refreshed and irritated. We don’t usually get home from the hospital until around midnight, usually unsettled from the latest unhappy turn of events, and so there is little time for restful sleep. Why, you may ask, did we not postpone this work until some less stressful future time? Two reasons. First, it took two months to get these guys here in the first place; they are very much in demand and we did not want to lose our time slot. When we scheduled the job, Syd was still walking and talking. Second, the improper drainage issue had to be addressed ASAP; we cannot risk another flood. As it was, we had two major rainstorms before Mud Monkeys did arrive, and with the bare cinderblock walls exposed, it was clear where and to what extent water was flowing in. When it rains it pours.

While all this goes on, I continue to ferry Shauna and her mom to and from the Veterans long term care facility at Sunnybrook, where we are in the hellacious limbo of juggling caregivers and sometimes negligent nurses to ensure Syd has the best treatment he can have. We have no idea how long he will survive, because so far he cannot ingest nutrition, but I understand that Shauna and her mom want to spend as much time with him while they can. We are not comfortable leaving Shauna’s mom alone in her house right now, but tensions are high, and this slow burn is affecting everyone. Mom Taylor is understandably distraught, but we are not going to leave her alone in her house without someone to make sure she takes care of herself, something she has steadfastly refused to do. I’ve been in this situation before, the only difference is that eventually, my mom did not have a choice. She fell ill and someone had to step in. Once again we are the meddlesome children, forcing an elder to deal with an unacceptable reality. We are the messengers. This is infinitely more difficult when the senior is of relatively sound mind and body, and adamantly refuses assistance. Some days I just scream into a pillow, or take a walk around the bucolic hospital grounds to remind myself what the past summer must have been like. I do believe there is a lesson to be learned from this tribulation. It concerns me that medical science seems to be increasing our longevity, seemingly in inverse proportion to our acceptance or understanding of quality of life ramifications. Next week, I will take a break from this morbidity and find something lighter about which to rant. To the two of you who are still reading this, you have my sympathies.

Written by Jamie Oppenheimer c2013 ALL RIGHTS RESERVED

The Oppenheimer Report 8/19/13

What Dad Taylor Saw
 

We got a call Thursday morning that Dad Taylor would be transferred to the Veteran’s wing of Sunnybrook Hospital the next morning, and so the roller coaster continues. By hospital standards he has stabilized, and there was nothing more they could do for him in the stroke ward. We had applied to have him transferred to the Veteran’s wing as a long term care option, and he was accepted faster than we thought he would be. Now, we have no idea what to expect, because he still requires constant supervision and his care is complicated. Nevertheless, I am relieved to have him out of that crazy stroke ward, because that was an unsettling environment in which to heal. He is now in a large single room, which is infinitely quieter than the stoke ward double he lived in for the past six weeks, with a series of four or five progressively worse roommates. The last was an old Indian woman who spent most of every night moaning loudly and making some other very strange noises. A few days ago I found out from one of her daughters - without inquiring I might add - the probable reason for her discomfort. A chronic laxative abuser, the woman had not eliminated since she entered the hospital over a week before. I was afraid she was going to blow on my watch and I fully expected to walk in one day to find windows blown out and nurses in HAZMAT suits mopping up the aftermath of her eruption.

After six weeks of being in the stroke ward every day, it is strange not to be going back. Every day I saw many of the same people. I’d walk in and before I got to Syd’s room, I’d be greeted by at least five or ten people I came to know. Many of the nurses, family members, and patients on the floor became my friends over the month and a half I was there. There is an inmate bond that occurs when one is in the hospital for so long. Last week, Shauna introduced me to a guy named George who was a retired Toronto firefighter who had served for 35 years. George is a character. I became fond of him almost instantly, he knew everyone on the floor, and I could always get the lowdown from George on which patient or nurse had misbehaved in my absence. George was on the floor because he’d had a stroke, but he suffered from a lot of other ailments as well, many relating to injuries he sustained on the job. George just found out, among other things, that he has lung cancer, and is now waiting to see if it is operable. He has been a wake up call to me because he never complains and he has a great attitude. I know that any of you still reading this blog must be about ready to throw in the towel, so oppressive has been the subject matter. But this has been the most meaningful journey I have been on in a long, long time, and I have learned a great deal. No matter how much I blather on about becoming more thankful, there is nothing like an extended visit to the darker side of a hospital to really drive that feeling home. I am so much more aware of and interested in people’s back stories than I was before and it has made my life more meaningful. Indeed I have been jaded, but before I start humming Amazing Grace, rest assured I am still the cynical wretch I have always been … perhaps I am just a wee bit less myopic.

Now that Dad Taylor is in the Veteran’s wing, things are entirely different than they were in the hospital. He is in the section for the patients requiring the most care; nevertheless, they have had him up and in a wheelchair. Sunday we brought him, fully dressed, down through “Warriors Hall” and outside to the garden courtyard. I put his hat and a pair of sunglasses on him. We cruised through the flowers and the past a lovely rock pond with falling water. The sun was shining. Perhaps I was projecting, but I think he knew he was outside and in a beautiful setting. Birds were singing, pecking at the bread crumbs on the ground under the “Do Not Feed the Birds” sign, and for just a moment the family could imagine that we were heading out to a picnic.

The night Shauna and I learned that Dad had to go back into the hospital, July 6th, we were out on my boat for a sunset cruise. The lake was like glass and we drifted in the pink dusk light. Reading her book, wearing one of her colorful sundresses, Shauna was the picture of serenity. I took a picture on my cell phone and sent it to Syd and Ethel. Syd was able to see that moment, and three hours later everything went south for him. Last week, Shauna celebrated her 55th birthday, and as I always do, I wrote her a birthday letter. In it, I mentioned that July 6th, before the bad news came, was “a moment”. In the past 20 years we have shared many such moments, many snapshots of serenity. I know there will be many others, and I will store every one of them in the scrapbook of my mind.

Written by Jamie Oppenheimer c2013 ALL RIGHTS RESERVED

The Oppenheimer Report 8/13/13

In the past four weeks I have watched some strange things happen on the stroke ward at Sunnybrook Hospital. One guy, who was at one time my father-in-law’s bedmate in a double room, was a “code blue” the other night. He was brought back to life and the next morning he was sitting up in a chair smiling and communicating with his wife and with me. I saw that guy when he was first admitted two months ago, and at the time I never would have assumed he would recover. I have now watched several people in recovery from severe strokes, and the progress is sometimes remarkable. My father-in-law’s brain trauma was seen to be so significant that the neurologist doubted he could ever again understand speech or communicate in any meaningful ways. Over the past four weeks he has done both and is showing signs of increased mobility. Although he had consistently failed the “swallow test,” Tuesday afternoon he successfully swallowed some applesauce, giving hope that he might be able to regularly ingest sustenance without a feeding tube. We do not know exactly what all this means, and understand he is still gravely ill, but it is proof that one should never give up hope. Doctors often cannot accurately predict if or how far someone will recuperate from brain trauma. My sister is one example; she made an almost full recovery. I have now seen at least four patients in this stroke ward who have amazed me with their recoveries. Having said all of this, there is such a minefield of complications we navigate every day in lobbying for Syd’s best care. Last Friday, he became visibly agitated, he was rigid, and started shaking. Obviously he was in discomfort, but he could not tell us what was wrong. It turned out he was running a fever and fluid was rapidly building up in his lungs. We dodged that bullet, but the ever looming question of when to throw in the towel and opt for palliative care haunts us daily. It is infinitely easier when the patient has made his wishes known, but Syd did not. Now we wrestle with the question,” what would he want?” The fact that he seems to be fighting to live drives us to believe we should help him try, but none of us is certain we are doing “the right thing.”

This past weekend I took a 24 hour break from my responsibilities as a devoted husband and son-in-law to drive down to Buffalo early Saturday morning and attend the Annual Western New York Offshore Powerboat Poker Run. This was my third year attending this poker run and by far this was the largest. This year over one hundred high powered offshore boats were in attendance, making it a record turnout. In our “classic” forty year old 27’ Magnum ( I LOVE that boat) we were dwarfed by a flotilla of newer, vastly more powerful (and expensive) super boats. The run basically took us to various checkpoints around Grand Island on the Niagara River, after which we made an open water run down to Angola, about 20 miles south of Buffalo. While not a rough day by Lake Erie standards, there was a healthy chop and we got some air.  In these lean times, when automobiles are getting smaller and more fuel efficient, this poker run is proof positive that wretched excess is alive and well in America. A LOT of fuel was consumed last Saturday on waters off Buffalo. One thing I like about this Western New York power boat club is that they donate a healthy portion of their proceeds to a charity called Excalibur, which provides boating experiences for the handicapped. This is a little, underfunded charity that provides huge benefits for the community. That is just one example of why they call Buffalo “The City of Good Neighbors.”

In the news last week, and speaking of wretched excess, it was reported on CNN last week that Japan’s debt has topped 1 Quadrillion yen; more per capita debt than any other developed nation. Former president George W. Bush underwent heart surgery for a blocked artery. See, he does have a heart, just no brain! Baseball star Alex “A-Hole” Rodgriguez got a 211 game suspension for alleged use of performance-enhancing drugs. Cheating in professional sports, who knew? Rodriguez will forgo $30 Million in salary and apparently now has a serious public relations problem for refusing to admit his indiscretions. Fess up A-Hole, it worked for Letterman. In other criminal news, gangster Whitey Bulger is presently trial in Boston. Also, they tore down Ariel Castro’s house in Cleveland. He’s the fiend who imprisoned those young women for years, torturing and abusing them. Strange that his neighbors and his own daughter never caught on. Will Russian anti-gay laws threaten Russia’s winter Olympics? As one humorist commented, there goes figure skating. Johnny Weirdo would be in prison faster than you can say “Would you like fries with your vodka?

 

Written by Jamie Oppenheimer c2013 ALL RIGHTS RESERVED

The Oppenheimer Report 8/5/13

A few weeks ago I mentioned a patient I’d met on the stroke ward named Betty. She is 88 years old. When I first met her she’d had what I think was her eighth stroke. Most of those strokes affected her eyesight, but left her otherwise relatively intact. I’d see her walking around the ward with her IV pole and occasionally I’d walk with her and chat. She’s a tall lanky woman, and I joked with her that she was a marathon walker. She’s very intelligent, and she didn’t seem to be put off by my oftentimes inappropriate humor. I have met a lot of humorless people in this hospital, so when I find a patient with a keen sense of humor, I tend to glom on. Last week, Shauna mentioned that Betty had been acting strangely, and was sitting in a chair blocking the entrance to her room, with her back to the hall. Later I went in to ask her how she was doing, and it became immediately apparent that she’s had another stroke, this time a bad one. Her speech was noticeably slurred and her coordination was off considerably. Most notably, she looked and acted dispirited.

Though we were not close, I thought she might want to talk about what had happened, and she seemed relieved to speak frankly about her situation. She has had visitors, mostly friends, who I think are not particularly interested in dealing with the reality of her situation. I’m no shrink, in fact I could probably use one right now, but this woman needed to vent and I was available to listen. She was clearly depressed and said she wished the next stroke would take her out. She hated the uncertainty, knowing that more strokes were imminent and that she would never resume anything resembling her life of three weeks ago. She felt as if she was simply waiting to die. We spoke for a long time, and because I have spent so much time watching people die of late, for some reason I felt particularly suited to offer my unschooled opinions on the subject. There are not a lot of people I know who will speak frankly about death, or quality of life issues, but with this stranger, who was facing her imminent or perhaps not so imminent demise, I began to discuss Dad Taylor and his situation. I think the act of getting it out in the open, not deciding anything, not coming to any conclusions, but still revealing the dark feelings, was cathartic for Betty, and perhaps for me as well. It was a conversation I had with my father, and one that I wished I could have had with my mother. Most people don’t want to talk about it, but living in denial worse. Taking stock of one’s life, no matter how compromised it becomes, and being truthful with yourself can be life-affirming. As I have said before I am not at all religious, but I have evolved into a more thankful person than I used to be. I enjoy searching for and finding the honesty that exists in all of us. If more people would get their noses out of their Blackberries, Droids, and IPhones perhaps we could once again develop a sense of community, something I think has been on injured reserve for a long, long time. There ends my self-righteous rant du jour.

Another roller coaster week of emotions for the Taylor family. Having met with the hospital ethicist and having heard all the opinions for Syd’s chances of a “meaningful” recovery, Shauna and her mom had conceded that palliative care was likely the imminent next course of action. That meant no feeding tube, no IV, and only comfort care to ensure Dad Taylor did not suffer as he drifted off peacefully. As fate would have it, the night of that meeting, he rallied significantly, creating legitimate doubt about pulling his IV. He is clearly communicating in a meaningful way, for the first time, and even I the skeptic want to buy him enough time to make his needs known, if he can. This is more complicated than I could possibly explain on paper. Weighing the risk of complications against the hopes that he can say goodbye; these are not easy decisions. We will certainly not let him suffer – there is no indication he is now suffering now, and his vitals are better than ever – but despite the hospital’s glaringly obvious inclination to free up a bed, I’m not convinced he’s quite ready yet. Denial? Probably a little bit. Hope? By its very nature hope it is beyond what we know. But there is powerful love in the Taylor family, and I accept the decisions that have been made, even when I do not fully understand them.

I went to look for Betty last night and she has been moved off the ward and into a rehabilitation facility off site. I wanted to show her a B. Kliban cartoon about which a friend reminded me the other day. The cartoon is of a woman staring at two empty boots with smoke coming out of them. The caption reads: “Due to a convergence of forces beyond his comprehension, Salvatore Quanucci was squirted out of the universe like a watermelon seed and never heard from again.”

We should all be so lucky.

Written by Jamie Oppenheimer c2013 ALL RIGHTS RESERVED