Coping With Loss

I’ve not been eager to write. The month of March has passed very quickly, yet [mostly] uneventfully save for the one thing I never thought I’d have to face.

And here’s where I am going to quite possibly write the shortest blog post I’ve ever written.

Friday, March 15th I had to put Oliver to sleep. Oliver was our stray, who turned up on my doorstep almost 8 years ago in a neighborhood full of strays, yet he belonged to none of the ferals we TNR’d and kept fed on our property. He was a tiny little orange kitten and he decided he was ours.

Over the years I’ve shared pictures of him and stories, videos of him “dancing” with Veruca. He was the first pet that was really mine in, maybe, ever. I worried incessantly over him, like I would my children. Worried he’d get outside, and get lost – or beat up by the strays outside where we now live.

Everyone who met him, loved him. He was beautiful, sweet, remarkably tolerant, and – big. He used to curl up next to me on the couch, half his body on my lap sometimes. He also loved Todd. He often curled up next to him instead of me, and I used to joke that he loved Todd more.

At 5:30 a.m. on March 15th, he woke me up howling. He was lying on the floor in the hallway outside our door, which was ajar. He couldn’t use his hind legs. He was vomiting and panting and howling.

Saddle thrombus is a life-threatening medical emergency. A blood clot that has formed in the heart breaks free and travels down the aorta where it lodges in the “saddle,” the point where the aorta splits into two arteries that supply oxygen and blood to the hind legs. This is where Oliver’s was, and why he lost control of both hind legs. I lifted his leg up and it just fell back down with no resistance. The pads of his feet were ice cold.

It’s also known as feline aortic thromboembolism (acronym, ironically – FATE) and is extremely painful. It’s often the first and only sign of heart disease in cats. The emergency vet told me that when they see cats in their facility, it is commonly saddle thrombus.

And sadly, no cure. Blood thinners can be used to try to break up the clot, but meanwhile your cat has no use of his legs and must be on pain medication to manage his pain. This equals long-term nursing care until he “might” regain use of his legs, and a recurrence of saddle thrombus is highly likely, leaving those who love him with the unthinkable decision to face.

The suddenness of this condition is what makes the shock all the more painful. He was not quite eight years old. He was perfectly normal the night before. I never saw this coming. I thought we had years and years left with him, chewing on my plants and sleeping in our laundry baskets full of clean clothes, sitting at the kitchen counter by the computer waiting for us to turn on his video game, and standing by the treat cabinet waiting for his handout.

My heart is broken.

 

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This Is Why I Drink

Yesterday was Monday and I got up for work. I put together food for Todd to take to work to get him started on a healthy diet and weight loss. It wasn’t a stressful morning. I even made him breakfast. We had a snow event Saturday and Sunday so we stayed in all weekend and cooked stuff and V’s dad brought her home for school yesterday so I wouldn’t have to drive in bad road conditions the night before.

Time to leave for work – completely flat tire on the rear left. Thank God Todd was still home so he fixed it and I was only 10 minutes late to work.

I was on phones yesterday in the morning. It’s January. EVERYBODY and their child has something. This week’s special: vomiting, diarrhea, and ear aches. I’m not mentioning the lingering cough we’ve all been reading about because, let’s face it, it’s now part of the regular menu.

Here follows an excerpt of my morning calls, or, what you shouldn’t do when calling your pediatrician’s office.

First difficult call of the day: I had to conference in a translator so I could register a new patient in Spanish. Patient is in his teens. We still accept new patients up to age 16, but Spock would say it’s illogical to go to the trouble of transferring in for only two years.

She wanted to schedule a well visit for him. Now. We need to have records in our office before we can schedule any appointments. I explained this, as well as the fact that we are scheduling well into March, April, and May. What? Oh no! He needs it NOW. She went on and on in Spanish for several minutes, because she was told by our office in November that she would have to call back in January. Ahem. NO ONE could possibly have told her that, because – need records first, then can schedule. Someone clearly misunderstood. She wasn’t backing down. Several more minutes of Spanish where I was able to pick out a handful of words which I shouldn’t have done because it made my head pound. Finally, I gave up engaging in this back and forth, since it wasn’t going to change anything. She still has to bring records in, she still has to change us to his PCP on her insurance, and we still DON’T HAVE ANY APPOINTMENTS BEFORE MARCH. Longest phone call ever, and it was still barely 10 a.m.

Next up: mom calling for a referral. That was the easy part. Then, both her kids needed well child visits; they’re due in February, and… SEE ABOVE. And – she wanted them both seen at the same visit. Easily spent 20 minutes on the phone with her trying to find a time for both children to be seen, NOT with their usual provider because that just ain’t gonna happen if she wants them together. Said she’d take any provider, but not the nurse practitioner (who has appointment availability sooner) because one child has “issues.” Found her an appointment in April with someone, and she happily took it. It just took forever to end this call.

Finally – and believe me there are several more I’ve blocked out – a dad called and wanted his son seen TODAY. By this time, we were completely booked and so I offered to have a nurse call and advise/direct him, or he could go to urgent care. This was before lunch.

Should I take him to the ER instead? That would be your decision… I’m not clinical so I’m unable make recommendations on that.

Well, can you schedule him an appointment for tomorrow?

I’m sorry, I cannot pre-book sick appointments for the next day. I can have one of our nurses call you and advise you and/or we recommend going to urgent care. Or, you can call back tomorrow morning and be scheduled then.

Well, who does the scheduling? I do, and nurses will schedule sick patients who need to be seen.

So why can’t YOU just schedule him for tomorrow?

I am not able to pre-book sick appointments for the next day. But again, I can have a nurse call you and advise you.

Where is urgent care? Will they take my insurance?

There is ******* in ******* or the CHOP urgent care location opens at 4 p.m. YOU will have to check with your insurance about coverage.

Well, can I speak to a nurse?

Absolutely. I will have her call you. What are your son’s symptoms?

He’s been vomiting and has diarrhea.

For the record, I always end my calls with a big smile, hoping against hope that it is felt through the air waves that I am very pleasant and not the least bit annoyed with difficult people.

Also for the record, we DO NOT see patients who have vomiting and diarrhea. And, in case you don’t already know, this is a VIRUS. It has to run its course and there’s absolutely nothing a doctor can do for you. Unless you are dehydrated and unable to keep even water down. THEN, go to the emergency room. Common sense, folks!

I’m just glad I wasn’t on phones after lunch, having to tell everyone who called that we have no more appointments left today. Sounds awful, right? But, this is the way it is in the winter. Everyone is getting sick and there are only so many appointments available in a day. That we were booked by 10:30 a.m. should tell you how many sick kids are out there. Which is why sick calls are triaged… so the nurses can determine who needs to be seen or who just needs home care.

And then today I woke up with headache and GI stuff and an enormous sore on my lip, something I’ve never had like this, ever. It started yesterday at work, and slowly grew but not terrible. This morning, it only added to the issues I woke with – and it is HUGE and ugly. And, it looks like there’s another one brewing on the other side.

The kids were fighting over the washing machine last night – imagine! So these are the arguments I’m diffusing nowadays. Now they’re both doing their own wash and I’m still reeling from the shock of having more time on my hands. Even Opac has taken on the challenge of unclogging a toilet – thus, I haven’t had to do this in a while either. Who ARE these kids living in my house? Still, no one is cleaning the bathroom.

I went to the store on Saturday, which we’ve already determined is to be avoided at all costs. But, necessity boiled over. I turned up an aisle of the parking lot and sat still in my car while three different people, WHO WERE WALKING TOWARD MY CAR, took up the entire aisle. Not one of them thought to move out of my way. Todd said, I’d have blown my horn. And I said, that’s precisely why I left you at home. People inside the store are no better. The rules of the road should apply to shopping cart etiquette but clearly most of these folks missed the memo.

The animals remain constant, though. Sabra is still freaked out by gunshots (we live in redneck land where no celebration is complete without gunfire). She’s shaggy and stinky again and needs the groomer. She runs from me when I pull out the brush. She acts uncomfortable on the couch when we’re home, but I KNOW she’s up there when we’re not because I see paw imprints.

Oliver lies on the couch every day, usually right after I’ve cleaned all of his fur from it. He continues his morning whine for canned goodness, and afterward waits on the kitchen stool for one of us to turn on his video game. For reals. There’s an animated mouse video on YouTube we put on for him, and he stands on the counter and bats at these mice like Rocky Balboa. Hey – it’s exercise. At least until he tires himself out and lies down on the counter and just watches them go by.

 

Miscellaneous:

Other things to keep in mind when going to your pediatrician:

We don’t prescribe birth control pills.

Pink eye = extremely contagious. You will not be seen for that. Prescriptions are called in.

You cannot be “billed” for your copay. (Well, it does happen, but generally speaking, NO.)

Do not, I repeat, DO NOT “walk in” to the office without an appointment. And, to that end, if your child fell through a plate glass door and is bleeding in multiple places, DO NOT go to the pediatrician’s office. You need to go to the ER.

Fevers that come and go with ibuprofen – will come and go with ibuprofen. In other words, fever returns when the medication wears off? Of course it does. And there’s never a dumb question or first time parent who doesn’t worry about what seems like the smallest things. Don’t be afraid to call for the nurse. Just don’t holler at the front desk person who has parameters to follow for scheduling sick appointments.

Likewise, please don’t holler at the scheduler who can’t pull well visits out of their ass for you. First come, first serve is a real thing ya’ll.

Don’t get mad at the front desk when your ex-wife told you the appointment time was a half-hour earlier than it actually is. Also, by the same token, do not involve us in your domestic disputes. There is nothing we can do about it, unless there are court documents.

When your child turns 18, they are a legal adult. They should be transitioning to an adult provider, but until they do, please know that without your new adult’s consent, we are unable to discuss his/her healthcare with you. It’s the LAW.

Finally, realize that your child is one of hundreds of patients in a practice. We care about all of them, but there are only so many doctors and nurses, and we can’t always perform miracles. Use patience and kindness when asking for what you want, and that kindness and patience will be returned.

 

 

 

The Weekend, Dreams, and Butthurt

I woke this morning from a terrible dream that involved the kids and my ex and Todd was in there somewhere too but incongruously juxtaposed with the ex, and there was this weird camp/event/gathering with strangers (who were friends in the dream but who I’ve never seen before in my life). We were having dinner at the friends’ apartment and there was this keg of red champagne that exploded like dynamite and somehow I was to blame because I’d partially opened it by mistake and then everyone there was angry with me. I tried to wipe everything down and suddenly was fighting with my ex, or maybe it was Todd, and crying about the fact that I was trying my best to clean up the blood-like spatter of this red champagne that made the house look like a crime scene. And then I left there for some marketplace filled with outdoor shops and flea markets,  there was a flood and I was floating along the rapids with my shopping cart, worried about losing the ibuprofen I’d just purchased for Opac.

I know what you’re thinking. I don’t do drugs.

Why me? Why do I have to have these fucked up catastrophic dreams where I’m either crying or running away from a serial killer? Too much binge-watching of Murdock Mysteries??

Why can’t I have dreams about swashbuckling pirates like my friend – who, incidentally, is a very physical dreamer and has frightened more people awake with her very loud vocals and thrashing about? It seems infinitely more fun than being chased by a whackjob who wants to kill me.

Sleep is overrated, apparently. The dog decided that she absolutely could not wait until morning to go out on the last night I could actually sleep through the night before V came home, and woke me up at 1:40 a.m. When I actually want to sleep – I can’t. Otherwise, I’m falling asleep on the couch at 8:30-9:00 every night because my eyes just can’t take it anymore. Poor Todd. I wasn’t much fun on Saturday night.

And speaking of sleep, the cat continues to sleep on the dining room table such that I’ve taken the tablecloth off, leaving the ugly vinyl padding exposed and I don’t give a shit. I’m so over de-fuzzing the tablecloth every night so we can eat dinner there. He knows he’s not supposed to be there, and how do I know this? Because he knows the sound of me picking up the water gun, and also because the minute he hears me down the hall he’s jumping off. I guess he thinks he’s fooled me, but it hasn’t occurred to him that I can hear the sound of elephant paws hitting the floor.

I noticed that he no longer sleeps with us when the kids are away, and he no longer sleeps with V either. I thought maybe something was amiss, especially since he doesn’t jump up on the couch next to me much lately either. But this morning it occurred to me that it’s too hot, and then it occurred to me that he only sleeps with us when it’s cold and NOT because he loves any of us, so in reality he is selfish and only out for himself. Which is why he doesn’t give a f@#% about the rules. YET, I continue to love him.

But not as much as I love Todd and IPA, which is why I woke up Sunday morning prepared for butthurt and to make it up to him for falling asleep so early the night before. We got up and cycled a 13.6-mile circle around our town which was exhilarating and satisfying and only momentarily embarrassing when our two lumps on bicycles were passed by a cycling club of about 8 sleekly-clad riders who knew the proper alerts to give me as they approached from behind. At least they were kind and asked, how are you this morning, though it should’ve been painfully obvious.

We got home and Todd took to mowing the lawn, and then I took over the push mower for the first time ever which I know must come as shock. I’ve never mowed a lawn in my life. I once rode a tractor in my old life, but only for about 2 minutes because I panicked when I let go the brake and the damn thing took off like a train. (Well, not really, but it was really scary when I forgot how to make it stop.) So, I can now check off another item from my bucket list. Not that it was on there. I find that it’s easier to add things to the bucket list after I’ve done them.

We ended up checking out a local place on the water we hadn’t been to yet, which turned out to be the very same vacant, for-sale property we’d checked out four years ago and talked to my mom about opening a restaurant in. Obviously that never happened, and – excuse my French – this place is now a fucking gold mine. And loud. But we enjoyed sitting outside on the covered deck, enjoying IPA and Crabby Mac n Cheese and loaded nachos, all of which I think were well-earned after the morning we had.

Lessons learned – don’t ever hesitate on a reasonably good idea. Although, I wouldn’t want the headache of a place like that, between the hell of staffing and security, not to mention the liability associated with its proximity to the water. I’m so over the restaurant business anyway, even as Todd keeps returning with these fantasies of owning a very lucrative, if not seasonal, one. Personally, I love the idea of a Monday through Friday, 9 to 5 situation, where somebody else is the boss and I only have to show up and do my job right. There’s absolutely nothing wrong with lower expectations. Well, except when you just want to sit down without pain.