This is a question that has been running through my head for quite some time. It’s not a thought emanating from a feeling of self-pity. Well, okay, maybe once in a blue moon, although I’m not one prone to a lot of self-pity. It’s more a thought that somehow, some way, there should be caretakers for caretakers. If only sometimes. Maybe that traditionally comes in the form of spouses. I have no idea since I’ve never really had one although I’ve been married twice, briefly each time. The question comes more from the role I’ve filled for the last several years of caretaker to my family members: my daughter, granddaughter, and now my elderly mom.

January 2012 started off with yet another hospital visit. This time it was my mom. The visit was only two days and although it was an upper respiratory virus issue that took her in, it was the low oxygen and very slow heart rate that kept her there. She has fantastic doctors so I wasn’t too concerned this time, but at nearly 93, any hospital visit with her is cause for concern. She’s home now and fine – a lingering sinus cold – but fine. Yet, throughout all this (and other hospital visits), the message I’ve heard from my family and friends has been “Take care of yourself”. My consistent response is, “I will” or “I am”.

Do I know how to take care of myself? Of course I do when it comes to the basics of feeding, housing, supporting myself. I wonder sometimes though if I really, truly, honestly know how to slow down, stop, get rest, and nurture myself. I think this is what they are really suggesting. And do I really want to? See, if I stop, I have to face facts. I face the fact that I come home to an empty home (unless you count the menagerie.) And I have to face the fact that I could lose my loved one – a fact that will eventually come true because no one lives forever.

And so what? It is what it is. I choose not to dwell in self-pity. Rather, I like to focus on the positive. It may be that I’m naturally Pollyanna-ish, but I also think it’s more of a habit I’ve acquired through regular practice. So, when I force myself to slow down and stop, to nurture myself with warm drinks, soft blankets, and a chance to exhale, I focus on the fact that I have a beautiful home, a home in which to invite family and friends and possibly a future mate. I focus on what I already have, not on what might be lacking. Most importantly, I remember that I have a beautiful family, full of kids and grandkids that love me and want me in their lives, a mother that needs, loves, and trusts me, and who is proud of me. And who I am grateful and honored to be allowed to be her caretaker at this precious time in her life.

So, who takes care of the caretaker? No one. And that’s okay. It’s just how it is as an adult. We no longer have a mommy to come to our rescue, so we need to learn to self-soothe. This year, my focus is on self-soothing in healthy, positive ways. Remembering and re-learning how to take care of me. This means getting back in the swing of my Weight Watchers and feeling better about myself and my body. (Losing weight is far more to me than just clothing sizes – it builds my confidence and esteem.) Taking care of me means getting enough sleep each night, taking time to have a few deep breaths, and most importantly, taking time out for people in my life other than the one I’m taking care of so they don’t feel forgotten, and so that I never forget just how much I love them too. And also so I don’t forget just how much I need them.

Taking care of the caretaker means that I also need to build a social life. One that has been neglected over the past few years. And laughing. God, how I need to remember how to laugh. Life can be so serious, and laughter is such a stress reliever with no calories attached.

Ok, enough rambling for now. I have to get busy and get to work so I can keep my fantabulous job that affords me flexibility and freedom to be with my mom worry free. Thank you, God.

And thank you for listening to my ramblings this cold, winter morning.

Sitting at mom’s last night, she quietly asks me, “Have you gained weight?”. Her tone was one of concern because she knows how hard I’ve worked to lose 81 pounds and she’s one of my biggest cheerleaders in my weight loss journey.

The answer is, sadly, yes. I’ve gained back about 15 of that 81 pounds over the last year or so. Not a ton  – all things considered – but it’s visible (at least to me) around the waistline and thighs. And I feel it.

What happened? Lots of reasons:

• Stopped tracking my food.
• Stopped paying strict attention to food portions and choices.
• Stopped exercising regularly.
• Increased stress, worry, and depression.
• Stopped putting myself first.
• Weight Watchers changed their plan and gave me more points, which I thought meant I could eat much more each day. Calories in. Calories out. It all adds up.
• Lost my walking buddies and didn’t replace them with new ones.
• Lost my bicycling partners and didn’t replace them with new ones.
• Hit menopause.
• Stopped going regularly to my meetings for support.

The good news:

• I know what to do.
• I can do it all again.
• I can start now, today.
• I can put myself first and my family will thank me for it.
• I can make better food choices and not go hungry – even when dining at mom’s place with her or dining out.
• I haven’t changed clothing sizes.
• I am determined and willful in a positive way.
• I have support of family, friends, and my Weight Watchers group.
• I can bicycle or walk or run by myself and don’t have to wait for others.

Can = will do.

Now.

Photo credit: http://comicadze.com/

At dinner the other night with my mom at the retirement home, one of the ladies at our table told us how she had just got a new set of “computerized” hearing aids. She had been unable to hear, really, for nine years, she said. I quietly observed her as she went around the room telling people how she could now hear everyone and the clarity with which she could hear them.

I remember when I got my first pair of glasses. I didn’t know how bad my eyesight had become until I tried out the new lenses. Trees really were green and there were edges to the leaves – things weren’t just a blur any longer.

Imagine going nine years sitting among people and not being able to hear the conversation. I can’t. I can only think of the feeling of isolation it must bring at times or the fact that one would really have to learn to read lips or sign language. Premature hearing loss runs on the maternal side of my family line, so this is something I think about occasionally – particularly when my youngest tells me I’m going deaf.

Watching the lady and her giddy joy at being able to hear – something most of us take for granted – made all my problems seem trivial and superficial. Being around the elderly for any length of time really makes you realize how unimportant many of our everyday struggles really are.

Image source page: http://www.moonbattery.com/archives/2009/11/pelosicare-hear.html

Just a quick new pic of me that was snapped at yesterday’s Seahawks football game. Thought you might want to know that even though I haven’t posted much about my weight loss lately, I haven’t gained it all back – just a little but I’m still on the path. Not much liking the new plan, PointsPlus, but I’m not throwing in the towel either.

Speaking of throwing in the towel…Time will tell what path the Seahawks are going to take this season. Let’s hope their first preseason home game was not indicative of the rest of the season. They pretty much sucked yesterday. Not horribly, but waiting till the third quarter to score against the Vikings was… um… dumb. At least my company at the game was delightful.

The universe has a twisted sense of humor if you can call it that. It’s not like I haven’t seen enough of the insides of hospitals the past couple years. It’s been a couple months since the last time my daughter had surgery, and my mom’s last visit to the emergency room was Easter Sunday.

Today, I just happened to be at my mom’s old condo about 15 minutes away from where she now lives in the assisted living home. She called and said she needed to go to the ER because she was vomiting. Off I went. It’s like an instant reflex any more. No emotions, I just go. Although I do get stressed when it comes to my mom. She’s 91 and one of these days the trip to the ER won’t turn out so well.

This time, however, we were greeted instantly by the same doctor who saw her on Easter Sunday. I really think he made a beeline for her when he saw her come in. He’s such a cool guy. And mom was funny. About an thirty minutes in she kept telling me that I didn’t need to stay. Like, um, where was I going to go, and how the hell was she going to get home? I stayed. An hour later, after IV and tests, she’s feeling better and kept asking for watermelon. That’s the first thing I got her when we got her home.

Anyway, short story short, we were only there for three hours and released. I kind of feel like the whole evening was a refresher course so I could remember my way around the hospitals. Um, I really didn’t need the refresher course, oh dear Universe. And please, don’t take me back there again any time soon, mkay?

Mom’s moving to a retirement and assisted living home. As part of that move, my daughters and I are helping her sort through her stuff to see what goes in the trash, what gets donated or sold, what comes home with me, and what goes to her new, 800 sq. ft. apartment from her 1200 sq. ft. condo.

Through that process, we came across some letters that I had written to my mother when I was at boarding school in Plymouth, England. I knew that when I was a teenager, from about the time I was 15, I started being conscious of my weight – for some reason I thought I was fat. I wasn’t. I was a slim 130 (if that) 5’6” healthy teenager. I was active in competitive swimming, school sports including the occasional cross-country run, every other weekend “expeditions” consisting of 20 mile hikes across southern England carrying a backpack (stuffed with contraband) and a sleeping bag.

My memories of my teenage years are somewhat fragmented but I had always thought of myself as healthy, albeit depressed a lot, but that’s a different topic. What really opened my eyes was this paragraph I wrote to mom:

“I’m on a diet. Today I ate only five carrots and a biscuit.”

My heart is broken when I look back at the young girl who was so lost and thought that eating only five carrots and a biscuit was a healthy diet. No one noticed that it was the sign of an eating disorder. And yes, I now think I probably had a pretty active eating disorder. The picture above is me at my high school graduation. I had a 23 inch waist at the time. I was proud of that.

Things soon changed when I went to college because I switched over to eating hamburgers and milkshakes and quickly lost that 23” waist. It grew even further about six months later when I became pregnant at age 18. Then I switched from eating 5 carrots a day to eating bread and sugar sandwiches.

Good lord. No wonder by the time I hit Weight Watchers I was nearly 100 pounds overweight. I would go in cycles of binging and not eating. Nothing was normal or healthy. I didn’t know what healthy was. I was never taught, or never witnessed, healthy eating.

Now I know better. And I’m glad I wrote that letter. It resurfaced at just the right time. My life focus is now on being healthy – body, mind, and spirit – and going to whatever lengths I can to make that happen.

Today, Easter Sunday, I spent the majority of the day with my 91 year old mother in the emergency room. She called me this morning at about 8 and said, “I need you to take me to the ER at about 9:45. I think I may have pneumonia.” The diagnosis from the emergency room is that she has “minor” congestive heart failure. Now, before anyone panics, she’s fine. And she’ll likely be around until she’s 101. However, I shared the events of the day on my Facebook profile and one of my friends commented that I am an “Exceptional Daughter” to my mom. This led me to thinking and wondering how I came to be that way.

In the emergency room, mom couldn’t hear much of anything because the batteries in her hearing aids died and we had no replacements with us. So when we got home and after she’d promptly replaced them and could hear me (without me yelling or her lip reading), I told her everything the doctor told me about her diagnosis.

“Mom, the doctor said you have congestive heart failure.”

“Oh! That’s what my dad died from.”

“Yes, mom. I know. I was there.”

And then the memories started flooding back.

At about 22 years old, my parents were still living in Europe and I was in Southern California, married, with two small girls (1 and 2-1/2). My grandfather – the only living grandparent I had – lived not far away from me in a retirement community. This was not an assisted living facility but more like ordinary apartments for seniors. My grandpa, like my mom is now, was very independent and was still driving occasionally. (Coincidentally, and I do not see this as being a portend to my mother’s fate, my grandfather was about 91 at the time.) My grandpa must have called me, or he called my mom – my memories here are unclear – and I dutifully went to stay with my grandfather until my mom could get there from Europe. I spent the night there and often woke up to him shuffling to the restroom and back. Then I had to call the ambulance (I think) and have him admitted to the hospital. At least, I think I did, but somehow he got there, and this was before mom got in town. I remember visiting him in the hospital daily. After just a couple days, mom was finally there (I think my dad was too) and it wasn’t long after that my grandfather passed away.

I guess ever since then it seems that I have been the one to sit by the bedside of the sick ones in my family. I’m not sure why but it seems to be what I do. I learned how to do it from a very young age.

So when my  mom called me this morning, I went on autopilot. I hurried up, got dressed, got down there, and sat in my spot by her bedside and asked questions of the doctor, listened carefully, watched the monitors, and made sure my mother knew what was going on because, just like my grandfather was, she’s still sharp as a tack. And funny. And her humor comes at unexpected times and if you aren’t listening, you miss it.

"So, Claire, it’s Easter, and I think we should take you somewhere really nice. How about a nice visit to the hospital?”

“Yeah, mom, because I really don’t get to do this very much, do I?”

And we both laughed.

I love my mom.

(P.S. Yes, I know the picture above is of Christmas and this story is about Easter but I love that picture of my mom and me.)

What lies along the path ahead, at least in the short term, is known. Longer term: unknown. I suppose that’s how it goes with everything in life.

We’re getting ready for my youngest daughter to have another major abdominal surgery on Tuesday (1/25/11). She is really stressed out about this one and worried about just how many times her body can handle general anesthesia. This is her eighth time in about six years of having to go under general anesthesia and her seventh major surgery. In five months, this is her third hospitalization.

This surgery wouldn’t have been necessary has the prior surgeon performed a CT scan and inserted drains after the hernia repair surgery he did in September. With this surgery, they will be cutting her open along her existing abdominal scar (about 12 inches or more) and removing a large abdominal cyst or mass. (They’re calling it this after a CT scan revealed it was not another hernia, as the prior surgeon said.) They’ll also be removing the extra skin that this mass has created, which has caused her to look like she’s nine months pregnant, and inserting two temporary drain tubes to help prevent a recurrence.

I can only imagine the emotional toll this is taking on my daughter when she has a new baby at home. She’s unable to be 100% there with her daughter and unable to carry her around for any length of time or do many of the things that most young mothers do.

There’s also the toll that chronic illness takes on the immediate family. We are a close family – or at least I like to think so. That’s what I’ve strived to create in my life. But it’s another surgery. Another change to normalcy – and yet the chronic illness almost becomes the normal. Since my daughter lives with me and is a single parent, I’ve played the role not only of grandmother but of a co-parent. I’ve picked up the duties that my daughter cannot do: carrying the baby up and down stairs, changing diapers, bottle feeding, placing her in her car seat, and more. Not complaining, just explaining.

It’s somewhat sad to say that we have a routine now when Stacy goes into the hospital. My oldest daughter  and her husband take the baby for however many days, and I care for my daughter – staying at the hospital with my daughter as much as possible, only coming home to rest and shower and let the dogs out. I have a couple friends who are always there during these times to help out however we need. We are extremely grateful for them.

So here’s hoping that the path ahead after this surgery looks bright for Stacy. For us all. I’m praying that this is the last surgery she needs. I’m praying that she can be the mom that she wants to be (and she’s a good one so far) where she can take her baby on walks, to play dates, to the zoo, to the beach, and have a full life with as minimal chronic pain as her body will allow.

And I’m praying that she’s fully recovered from this surgery in time for Laila’s first birthday party in March. That’s the bright star in the path ahead.

So, thought I should follow up on the issue I had recently with the paramedics who came to my house when my daughter was vomiting blood. (You can read that story here.)

I sent a complaint letter to the fire department and copied every name I could find listed online. Surprise of all surprises – seriously, I was stunned – about 15 minutes after I hit “Send”, I received a phone call from the Assistant Chief of the Emergency Medical Services division. He was sincere, took my complaint seriously, and promised to do his own investigation into my allegations and then follow up with me with either apology or explanation, or both.

True to his word, after the holidays last week, I received a follow up call from him. He had gotten reports from all three of the personnel who arrived at my home and then had a meeting with them. Surprisingly to me, the woman was the paramedic, not the main guy that talked to me all the time. (And as an afterthought, if the woman was the paramedic, why was she also the driver on the way to the hospital? Does that make any sense?)

Anyway- here’s the long and short of it. And, by the way, I was impressed with how clearly the Assistant Chief understood my issues.

• When the medics arrive on the scene they try to find a common ground with the resident and/or patient or both to put them at ease because it can be intimidating to have all this equipment and people suddenly invade your home when your loved one is ill. This makes sense to me. However, this guy’s comments were just a tad “off”, and to be honest, I was already sensitive to just how much Christmas we already had going on.
• Next, they have to determine if the patient requires basic life care or emergency life saving treatment. They decided that my daughter just needed basic life care (their words, not mine.) Ok, fair enough.
• Once they decide that the patient is stable (my words) then they decide whether they transport the patient to the hospital or the patient gets there on their own. In our case, this is what happened, however it was never expressed that she SHOULD go to the hospital or even “gee, you should get checked out for that”.
• Finally, the medic’s focus on the anxiety or depression implied that my daughter’s issue was psycho-somatic. Clearly, the assistant chief agreed, the wrong approach.

So, ultimately, the guy that I took issue with was counseled on his approach, his comments, and so on. I felt like the situation was resolved to my satisfaction, although I’m still a bit curious about the female paramedic driving on the way to the hospital – what if there was a medical emergency en route? Makes no sense to me.

The Assistant Chief stressed to me that he wanted to make sure that any of their 200,000 citizens that they serve would always feel confident calling 911 if there was an emergency without hesitation or concern about the level of service they might get. I can say I will not hesitate to call ever but this was a lesson for me in learning to speak up for myself, and advocate for my daughter when I need to.

Bottom line, I’m glad I wrote to them. And now I’m glad it’s resolved and I can move on. Not that I lost a lot of sleep over it. And I pray I never have to call 911 to this house again.

I normally refrain from excessive use of exclamation marks (excessive = any unless in instant messenger) but I must use one now. After nearly three days in the hospital, four units of blood, two procedures (one failed, one successful) to repair an upper GI bleed, and seeing the insides of three different hospital rooms, my daughter is home. We both feel like we’ve crawled out of some dark hell-hole.

Thank God we didn’t listen to the insane paramedic who seemed to think her vomiting blood was of no real emergency or concern. And, by the way, I am drafting a letter to send to the assistant fire chief of his unit plus whoever the head honchos are in the Snohomish County Fire District and I’m reporting his conduct as unprofessional and quite possibly malpractice.

My daughter was diagnosed with an upper GI bleed in the form of a bleeding ulcer. I asked the gastroenterologist what caused this. Nutrition? Stress? He said it was from the way her stomach is constructed as a result of her gastric bypass some seven years ago or more. The ulcer was located at the junction of her stomach and small intestine – a junction that was surgically created. He also told me that the risk of recurrence was low. She’ll have to be on a medication, such as Prevacid, for the rest of her life, however. Had we known then about the complications from her form of gastric bypass (Roux-en-y and not the laparoscopic procedure) then, we probably would have considered yet some other form of help for her weight. However, she’d tried everything else we knew of so it seemed to be her only option at the time.

Now we have one more potential obstacle to get through. She has to see a couple surgeons for second opinions about possible complete abdominal reconstruction surgery where they will rebuild her abdominal wall and repair the hernia (for the THIRD time). The alternative to that as we understand it now is that without it, she will continue to have hernias and a protrusion on her belly that makes her look perpetually nine months pregnant.

Finally, I have to work my ass off to play catch up with work… and hire someone to clean my house. Thank goodness for my older daughter and her husband who have – without hesitation – taken over for caring for little baby Laila while I work and my daughter recovers. Hopefully her baby can be home with her soon, although I know all the cousins are having a blast together. I’ll post pictures as soon as I can get them from my oldest.

We’re all looking forward to a peaceful, non-eventful Christmas!