Posts Tagged ‘Nyel’

On Being a Commuter… and a Regular!

Monday, May 27th, 2019
SRO for Bayside Singers at Memorial Day Program

The Bayside Singers Perform for SRO Crowd in Oysterville

Day 31 — In our Sunday Night “conference call” last night, Charlie and Marta both remarked that I was almost “commuting” between Portland and Oysterville these days.  Well, not quite.  But it is true that this morning I made the 135 mile trip from St. Vincent’s to Oysterville for the third time in the last eight days.  Still… not quite commuting or at least so I thought until I made my usual pit stop at Safeway in Seaside.

After a dash to use the facilities I went to the Starbuck’s window and, before I could utter a word, the barista said, “Do you want your usual — a tall decaf mocha, double shot, no whipped cream?”  “Yes!” I said in amazement!  “How did you know?”

“Well,” he said.  “I wouldn’t remember your name even if you had told me, “but I’m usually pretty good at remembering what our regulars order.”  Wow!  So, maybe I am a commuter after all!

Sydney Reading “In Flanders Fields”

On this particular morning I headed right for the Oysterville Church where I had promised to take Nyel’s place in reciting (in my case, reading not reciting) “In Flanders Fields” as part of the Ninth Annual Memorial Day Program.

Afterwards, I again substituted for “General” Nyel, explaining to the crowd how we happened to form The Honorary Oysterville Militia and get the cannon in preparation for Oysterville’s Sesquicentennial in 2004    Pvt. Tucker Wachsmuth was the one who took charge of the cannon firing with the special help and  support of Capt. Ron Biggs, Lt. Pat McKibbin, Chaplain, Lt. Phil Coffin and neighbor Mark Seifried.  Nyel called shortly afterwards and swore that the bang could be heard clear off in Portland!  (No doubt it was the meds talking… but never mind.)

General Nyel and The Cannon in Plummier Days

Patient Nyel also reported that they are gradually shifting from IVs to oral meds in preparation for his move to a rehab or swing bed facility.  Fingers and toes crossed — it may happen later this week!

“They told me to take off my wedding ring…”

Wednesday, May 22nd, 2019

Wedding Ring Amongst The Miscellany

Day 26 — During the time that I was in Oysterville, “they” adjusted Nyel’s pain meds once again.  He had been in misery on Day 24 mostly, we think, because the the nurses are SO inconsistent about giving him his meds on time.  If they are late and he experiences break-through pain, it takes several (on-time) dosages to get him normalized.  Some nurses are timely.  Some are not.

The ones that are not always have excuses — “I was busy with another patient” is the most common and hard to argue with.  My personal favorite (NOT!) is the “He didn’t ask for it so I didn’t think he needed it.”  I think I might have raised my voice just a tad:  “He’s on a scheduled dosage!!!”

Nyel-The-Mixologist

In response to that particular go-round, “they” added yet another pain med.  Sometimes the two were being given together.  “No, no, no” said yesterday’s nurse.  You have to wait at least a half hour.  Those drugs are not good together.  Why is he on THAT schedule?”  I think her question was rhetoricaL… but it’s hard to tell with these Providence nurses.

When I walked in this morning Nyel said, “Those people are talking to me again.”  The “people” come to him when he is dozing.  He knows they are not real but, apparently, that doesn’t help matters.  “They told me to take off my wedding ring.”  And so he did.  “It’s right here on the table by my glasses.”  After I retrieved it and put it safely in my purse I asked, “And if they asked you to pull out your IVs, would you??”  “Probably,” was the answer.  YIKES!

Nyel’s White Board

So I ratted him out to Jon, his new nurse-of-the-day.  “He shouldn’t be given these pain two meds together — not even if they are given a half hour or hour separately.  One or the other.  Not both!” and Jon has crossed off one of the pain meds completely.  I didn’t know he could do that without a doctor’s order.  But I actually know very little…

The Tall and The Short Of It

The last time Nyel hallucinated it was in the ICU after his big “clean out the hardware” surgery early this month.  On that occasion he was an amoeba with millions of other amoebae.  They were racing for their lives in a game for which there were no rules.  Nyel said he lost and was then going down a ramp to the next game, also with no rules.  When he told the ICU nurse about it, she said, “Oh yes!  That’s called an ICU delirium and often happens after you’ve had anesthesia.  There have been a lot of studies about them.”  I looked online…  Wish I hadn’t.

As usual, my every instinct is to bust him outta here… where are Jack Nicholson and Morgan Freeman when we need them?

 

OBH even had Nyel’s dinner waiting!

Saturday, March 16th, 2019

Nyel’s Dinner

Dorothy had it SO right!  There is no place like home!!  When we finally rolled into the Ocean Beach Hospital in Ilwaco about 6:30 last night, Nyel had been “pre-admitted” (he only had to sign the paperwork) and they had kept his dinner warm for him!

Not that he had much appetite.  That’s been one of the sure signs that he is not a well man.  In thirty-five years, I’ve never known Nyel to willingly skip a meal but he’s passed on a number of them in the last few weeks.  He confided to me last night that he absolutely wasn’t hungry but he made a valiant try at eating out of sheer gratefulness.  He was, at last, on home territory!  People were greeting him by name!  Care by people who know him and truly want the best for HIM, What a concept!

The dinner menu was tilapia and Brussel sprouts – both of which Nyel really likes under ordinary circumstances.  He took a few bites, but he is still “up to here” in the feeling-full department – a direct result of his congestive heart failure.  He looks forward to improvement soon.  After all, food is one of the few pleasures open to him at the present time.  Plus, he knows he’ll have some hard work ahead in the physical therapy department and he’ll need nourishment and energy to help him through!

Nyel Tucks In

I drove home feeling better than I had for days.  Even his discharge form St. Vincent’s seemed to be a total cockup!  He had called me at eleven and said, “I’m outta here!  They are getting my discharge papers ready.”  I was at the designated pick-up spot by two.  Three or four phone calls and an hour and a half later, they finally wheeled him out to our car.  Apparently, the slowdown was due to Erica-the-nurse-of-the-moment.  “What was the problem?”  I wondered.  “I’m not sure.  She just seemed to have one speed… slow.”

It wouldn’t have mattered a twit except that Ocean Beach Hospital had asked that he arrive before the shift-change at 7:00.  We made it… but not by much.  I wouldn’t even be mentioning this last frustration except that it seemed the final irony.  Even getting Nyel discharged was difficult.  Well, never mind!  Onward and Upward!  I can’t wait to tell the chickens that Farmer Nyel is almost back home!

Onward? Upward? Hard to say…

Thursday, March 14th, 2019

Yesterday, shortly before dinner, Nurse Mario came into Nyel’s hospital room and announced that they were transferring him up to the 8th floor where they could monitor his heart more closely.  Yay!  Finally, the hospital gods were paying attention to Nyel’s needs and a positive step forward would be taken!  Or would it?

When Mario arrived with this latest news, we were still expecting the promised conference with Nyel’s “Care Team.”  They had not been able to pull it together on Tuesday when I had requested it as a “next step” up the steep slope of hospital protocol when one is not satisfied with patient care.  The meeting had been postponed to yesterday morning.  Then to yesterday afternoon.  Then, before we could say WTF, he was being transported up to the eighth floor.  Apparently, the care conference was off the table.

New Room

Initially, we were pleased.  The explanation Mario gave us led us to believe that this was so Nyel would now have better access to the cardiologists who would be taking the lead in his care.  His progress with the orthopedic part of the team had been sufficient so that, under other circumstances he would be sent home.  (And, by the way, one of the “Case Managers” dropped in to say, Ocean Beach Hospital has changed their mind; he is not a candidate for their swing bed facility.  Because of his congestive heart failure.)

We were feeling a bit blind-sided (but in a good way) about the move to this eighth-floor room until Nyel’s new nurse explained that this is not a cardio unit, as we had been led to believe.  The same hospitalist(s) will be overseeing Nyel’s care and the same physical and occupational therapists will be working with him.  The major difference in locations?  This room is on a newly renovated floor and has telemetry capabilities.  He is now hooked up to a heart monitor and someone “down the hall” can keep an eye on his heart rate and rhythms.  Otherwise… same old, same old.

3/13/19 – Another Step Toward Home

Who made the decision to move Nyel?  Why was it made?  Is it something that we are in agreement with?  All moot questions, apparently.  At least this hospital remains consistent in its determination not to involve the patient with regard to his care.  As it happens, we had a visitor all afternoon who witnessed the transfer process – from Nurse Mario’s announcement to helping schlep Nyel’s “stuff” from Floor 3 to Floor 8.  She didn’t happen to stay long enough to learn that not much has changed.  I’m eager hear what she thought had transpired.

Even though I strongly suspect that we have somehow gone through the looking glass, I am continuing to ask for a Care Team Conference.  As far as we can find out, it is the only option still available to us with regard to having a say in Nyel’s care.  Or to registering our uncertainties about what is being done for him.  The odds of it happening? Probably slim to none.

So… here’s the skinny!

Wednesday, March 13th, 2019

Yesterday Nyel was (apparently) privileged to be part of the ‘Providence St. Vincent Medical Center Department of Nursing Monthly Skin Evaluation’.  According to the handout that was supplied by the “Skinny Nurse” (as they call the designated skin-check-nurse on this floor):  As a part of our nursing department’s ongoing quality improvement efforts we evaluate all inpatients on a given day once per month for any skin problems.  This is over and above the assessment your assigned nurses do each day.

What Nyel and I understand from that is that if you are “lucky” enough to be in the hospital on the particular day of the month that is the designated “Skin Day,” you get an extra examination.  We are not sure how this helps the many patients who are in the hospital only on the other 29 or 30 days of the month.  If this skin check routine is part of some “study” or for the benefit of the staff, it might make more sense.  As it was presented, though, Nyel and anyone else who happened to be “in residence” on Tuesday, March 12, 2019, get a bit of extra attention – part of an ongoing improvement effort but only for some???  Hmmm.

‘I don’t know what these dots are … but ya mind if I connect them?’

The information sheet goes on to say:   The evaluation is done by nurses who are experts in skin care issues and requires that they look at all your skin surfaces.  It will only take them a couple of minutes to do this… They will come in pairs and identify themselves to you…. The “pair” turned out to be a single person who has been Nyel’s day nurse several times during recent rotations — a nurse we like very much.  Yesterday he was wearing his specially trained “Skinny Nurse” hat.  No one was with him.

He looked at specific areas of Nyel’s skin that he remembered as problematic from previous days – “all” skin areas as designated on the handout were not a part of his procedure.  In fact, he needed reminding that Nyel had a skin tear (perhaps from tape) near his surgical incision that a wound specialist had been called in to look at several days ago.  Sigh…

Still and all… it’s nice to think that Nyel is among the few who are benefitting by this bit of extra attention.  Yay!

One Step Forward, Two Steps Back

Tuesday, March 12th, 2019

It’s a familiar dance step – one that goes with a variety of tunes.  Curiously, it doesn’t have a name – at least not one I can find among the 37 dances listed in the Oxford English Dictionary.  Not one dance from #1 “Pop Goes The Weasel” and #2 “The Virginia Reel” to #36 “The Rumba” and #37 “The Shimmy”  — not one is based on that familiar pattern of one step forward and two steps back.

But, even so, it is the step-pattern of choice here at St. Vincent’s Hospital.  There are a few variations, of course.  Sometimes there are three or even four steps back and, sometimes no step forward at all.  It’s all very confusing to the willing learners such as Nyel and myself.  And, the confusion is often compounded by the dance instructors (read doctors), themselves.  Not only do they disagree with one another, they often (apparently) disagree with themselves.

Take yesterday, for example.  A dance instructor (read doctor) from another dance team (read medical discipline) came in for a consultation.  His suggestions for a change in the dance pattern sounded terrific.  It seemed that his plan would soon have Nyel moving two or three steps forward without backward movements or even dips.  But, somehow, there was a change in his thinking after he left here and his original plan was scrapped.  Nyel’s dance routine was suddenly in a reversionary mode – steps that were tried days ago, and were found ineffective then, have been put back in his routine.

We’ve requested a conference with both dance instructors together.  Although both have agreed, they have come in separately.  That has happened twice this morning – they apparently don’t understand the terms “conference” and “together.” One comes and justifies one thing.  The other comes in and justifies something else.  Perhaps they are still trying to coordinate.  The only thing that seems consistent is that Nyel will not be leaving this dance studio for the foreseeable future.  Probably not for another week.

Through the magic of cyberspace, Nyel is in communication with his Number One Danseur in Seattle who has offered to consult with these St. Vincent’s’ hoofers if they initiate the request.  Neither Nyel nor I believe that they will consider doing that.  Stay tuned… if you can find the appropriate melody.

Hip, Heart, Hallucinations

Friday, March 8th, 2019

Nyel and Physical Therapist 3-7-19

This morning begins Nyel’s eighth full day as a patient at Providence St. Vincent’s Hospital in Portland.  When he arrived in the wee hours of March 1st, the focus (of course) was his broken hip.  That has been repaired and all protocols have been put in place for his healing and eventual recovery.

Once the hip was repaired, his orthopedic team was alerted by his Number One Advocate (that would be me) that perhaps a bigger issue might be his long-term congestive heart failure.  Eventually, a staff cardiologist was consulted and has weighed in on matters such as diuretics and blood thinners and other medications.  Yesterday there were some dramatic changes.

Most gratifying was a twelve-pound fluid loss in a twelve-hour period.  Yay!  That slowed down to a three-pound loss last night but, gradually the 27-pound accumulation of fluids is diminishing!  Today they are re-starting his blood-thinners which is also a huge relief to me, though the ortho team has assured me that his system has retained enough to prevent clots. (I would like to hear that from his UW cardiologist or even from the consulting heart man here.)

Casey Comes Visiting 3-8-19

During all of this, patient Farmer Nyel, has been enduring severe muscle spasms around his left hip.  They have given him muscle relaxants to help that situation but he had a surprising reaction.  After a period of deep (unable-to-be-aroused) sleep, he informed everyone that he had been visiting a monastery that was apparently under restoration.  “There were stained glass windows on the wall to my rightt and there was a lot of scaffolding behind me.”

He also reported having several conversations with staff members whom he knew, even at the time, were not present in the room.  In fact, at one point, he appeared to be asleep and reached out to accept something (a glass of water?) as he said with eyes still closed, “I believe I’m hallucinating again.  There’s no one there is there?”  It wasn’t scary – not to him or to those of us observing him – but it was decidedly weird.  They have changed muscle relaxants so we shall see…

All in all, Nyel’s care seems more inclusive and we are seeing some positive progress.  His work with the therapists – occupational and physical – has picked up after skipping that day of deep sleep and interesting visions.  Yay!  Back on track.  The Homeward Track we hope.

Reunited At Last!

Tuesday, January 29th, 2019

Coopward Bound!

Yesterday, with very little fanfare, Nyel mounted his Knee Scooter and headed east.  Through the south garden, over our scraggly winter lawn and down to the chicken coop.  The girls and boys, ever attuned to goings-on beyond the coop, gathered at the hog-wire fencing and watched his approach.  They were quiet – perhaps awe struck – as they tried to figure out what was coming their way.

I thought briefly of the rabbits in Watership Down and their fear of motor vehicles which they called hrududil (plural for hrududu.)  I wondered what chickens would call a knee scooter and if they even recognized that it was Farmer Nyel who was propelling it.  As always, it’s hard to tell with chickens.  It was even hard to tell with Farmer Nyel – I don’t know if he was expecting a little more fluff and flurry after his three-and-a-half-month absence.

Waiting for Farmer Nyel

Perhaps of greater importance to the flock was their release from confinement.  As soon as I was safely back in the house and out of harm’s way from that killer rooster, Farmer Nyel opened the gate and let them into the yard – also a first in three-and-a-half months.  He reports that they were initially a bit tentative but, with the enticement of some scratch, they were soon off and pecking – Backyard Chickens once more, ‘just as God intended” as our friend Ti would say.

Nyel spent an hour or more doing his Farmer due diligence – cleaning the coop, putting fresh cedar shavings on the floor and in the nest boxes and, generally checking things out. As requested, he called from his cell phone when he was ready to head back to the house.  I wanted a picture of Farmer and Flock and was willing to brave a confrontation with you-know-who to document this big red-letter day.

Reunion

But, no worries.  When Farmer Nyel paused in his homeward trek, all seven chickens gathered round for the offered treats with ‘nary a glance at me.  The little red hen even ate from his hand just as she had done in the past.  Who knew there was enough memory space in that teeny-tiny brain to remember that trick!  Nyel didn’t let on but I’m pretty sure he was pleased.  As for the chickens… I’d wager they were, too.

Noreen, Nordstrom’s, and Nowadays

Thursday, January 17th, 2019

BIG but Too Small

“It ain’t like it used to be” is almost a mantra in our household these days – a sure sign that we’ve grown long in the tooth and, probably, not gracefully.  This morning it had to do with Nyel’s current foot and shoe problems.

Although he has his surgeon’s okay to put weight on his foot, he is finding it impossibly painful to do so.  As in so many problems to do with health and lack thereof, the reasons for this are probably multiple, arthritis being the main culprit.  For years now, Nyel has worn custom-made orthotic inserts in his shoes which help alleviate said pain but, currently, his left foot is so swollen that he cannot get his shoe on.  The reason for the swelling says his primary care doctor is “a combination of surgery aftermath and his congestive heart failure problems.”  Great.

First Nordstrom Store Seattle

“Maybe you’ll have to have a custom-made shoe,” said I (helpfully, I hoped.)  Nyel already wears a size 13 Triple E which is the largest he’s been able to find in the type of shoe he needs. There was a long silence following my suggestion.  You know – that kind of silence which tells you that you have been the opposite of helpful.  But then the conversation segued into “remember when Nordstrom used to specialize in foot and shoe problems?”

Nyel got his first Nordstrom credit card (which they won’t let him use anymore) in 1966 – just three years after the (then) 55-year-old store had begun carrying some items of women’s clothing.  They had started as a shoe store, Wallin and Nordstrom, in 1901 and prided themselves on service.  As we “remembered” all that, Noreen came into the conversation.

Noeeen Robinson (1925-2006)

Noreen Robinson had suffered from polio as a child and it left her with disparate sized feet.  She once told me that she had always purchased her shoes at Nordstrom – the left shoe and the right shoe each from a different pair.  And even though they had to break up two pairs to make the sale, Nordstrom’s only charged her for one pair.  Noreen swore by Nordstrom!

Now that they are digitized, incorporated, up-scaled, and out of our network, we doubt that their customer service extends as far as it did in Noreen’s time.  But… maybe it’s worth a phone call to see what would be entailed in getting a custom-made shoe.  Especially if elevating, wrapping, icing, and all other shrinking methods don’t work.  But… I suspect we’ll find “it ain’t like it used to be.”

Cruising Toward 2019

Monday, December 10th, 2018

Today is a Red Letter Day of sorts.   Nyel is taking the driver’s seat!  Literally!  It will be the first time since his Big Fall on October 3rd – the one that resulted in his complicated leg break – even though his surgeon said that he could drive as long as he wasn’t taking opioid pain meds.  He hasn’t and isn’t and, though I am reluctant to admit it, I’ve been the one that has encouraged him to continue being chauffeured.  By me.

We both recognize that we are victims of one of those automatic hovering mothering mechanisms that kicks in whenever someone (other than me) in the household becomes impaired.  Nyel has learned that it’s easier to take a “whatever…” attitude than to deal with my fussing and, so it is, that I’ve been doing all the driving.  Until today.  When the EMTs arrive to transfer Nyel into the car, it will be to ease him behind the wheel!  He’s more than ready.  I am resigned.

I see it as one of those necessity things.  I have an eye appointment across the river – a biggee to check my glaucoma, dry eye, peripheral vision etc. etc.  There will be drops.  In the past it has been my experience that I do not see well enough to drive safely for twenty-four hours or so after such an appointment.  So… today is the day that Nyel re-enters the mainstream, so to speak.  I console myself that, after all, it’s his left leg that isn’t operable, plus we have an automatic transmission and cruise control.  No problem, right?

And besides all of the above, today marks the “less than a month to go” before his next appointment with his surgeon and, presumably, his release from this “non-weight-bearing on the left leg” sentence.  January 9th will be the next Red Letter Day!  Woot! Woot!