It ain’t over till the fat lady sings…..

fat-lady5.jpg

“It ain’t over ‘til the fat lady sings.” Now there’s a phrase! It has a special meaning for me today: I just came back from a trip to one of my doctors, the delightful one who specializes in infectious diseases. It is she who will determine when I am ready to undergo another surgery to remove the concrete spacer lodged in my right hip and replace that with a new prosthesis. Needless to say, I was anticipating her assessment, though I bragged to Lisa and Jon that I was not allowing myself to count on a specific date or a result or any such thing, because I didn’t want to be slapped upside the head one more time.

Well, I talk a good game. The doctor said, “Wow! Your lab test results are looking good. Obviously our therapy is working; you’re just a slow responder. Let’s keep doing what we’re doing, and I will see you in three weeks.” Three weeks! Despite my brave talk to my children, my heart plummeted to the vicinity of my ankle bones.

Here’s my lesson: it ain’t over till the fat lady sings. The adage essentially means that one shouldn’t assume the outcome of some activity (frequently a sports game) until it has actually finished—or that’s what it means for many of us. The phrase is often attributed to sports commentator Dan Cook who made this remark in the late ‘70’s, in relation to the NBA playoffs. However, in another form, the phrase is, “the opera isn’t over until the fat lady sings”, and conjures up a vision of Brünnhilde (a very large Valkyrie) singing, and then riding onto Siegfried’s funeral pyre at the end of Wagner’s ring cycle.

Her blond braids hang down from under her horned helmet, and she is clearly a ‘woman of size’. And finally, in the South you will hear “church ain’t over until the fat lady sings”, referring ungraciously to a robust member of the church choir, I’d guess.

Regardless of its origin, the adage means the same: it’s a form of self-reassurance (or denial) in the face of long odds, and is usually muttered when things look grim. It’s the phrase that came to mind when I heard “See me again in three weeks.” What it meant to me was “Three more weeks at Orchard Creek”, and it reinforced the helplessness of being in a position where nothing I could do would alter the decision: it was out of my hands. My hoped-for outcome was not going to happen, and I will stay at Orchard Creek for three more weeks, or until my Medicare allotment of 100 days has expired, whichever comes first.

I listen to the concerns of the patients here at OC and I have a deeper respect for the obstacles they face: Miriam and Norm can’t afford to be in the supported living apartments and don’t know where they will go; Roseanne must leave her cozy house and live for a time with her son—she wonders if she will ever go to her own home again. It’s amazing, I think (not for the first time), that their spirits are high and that my companions keep working toward better health and self-sustainability.

They all must know the meaning of “It ain’t over ‘till the fat lady sings.”

fat-lady2.jpg

Healing is a personal journey

 

 

tickle.jpg

“Healing is a very personal experience.” I found this observation on the internet somewhere and saved it—it gave me a new way to look on my experience here at Orchard Creek and on the journeys of my companions. The very purpose of the OC facility is healing: all of us here know that once our physical capacity is increased, we can leave here: we are all on a healing mission, and we all intend to leave this place. That makes Orchard Creek quite a different environment than ‘old folks homes’: we have a reason for being here and it’s far different than the passivity of just living until the end of our lives.

As I looked about me at my OC companions, I began to observe them in the light of their personal healing journey. I think about us right now, awaking early in the morning, facing a new day. I know myself that some ‘new days’ are bleak: I lie in bed, hurting, reluctant to begin another step toward the end of this. I am thankful for my personal coach, Debby Werthmann, who anticipated this problem, and gave me a digital voice recorder. I then recorded 20 minutes of affirmation statements, which are there for me whenever I need a little boost (or even a big one).

For other residents, facing the new day is also difficult. For some, the obstacles are physical: when you are handicapped, a shower is a huge and draining undertaking. For the depressed, morning rituals of washing and brushing seem senseless and futile. And for some, like Bob, singing and laughter is the answer.

Even as I write this, I hear the aides moving down the hall, knocking on doors, opening them, and calling out “Good Morning, Lucille. It’s seven o’clock.” In every instance there is a moment of conversation and easy laughter before the aide moves on to the next door, leaving behind a friendly welcome into the day.

In her article “For Free Healing Learn How to Laugh”, Debbie Mandel says “Laughter has wonderful physiological benefits. Doctors call humor the inner treadmill as it has benefits similar to exercise. To name a few: Problem-solving ability is enhanced by laughter because it helps the brain to de-stress and do its work without distraction. Laughter also provides an important relief for those of us suffering from pain through the release of endorphins. In addition laughter improves respiration, increases the number of immune cells, lowers blood pressure and decreases the likelihood of a second heart attack. Certainly, nothing to sneer at!”

I’ve often remarked in this blog about the laughter at Orchard Creek. I know that whenever I do go home, I will miss being awakened by laughter at the nursing station at 2 AM. It’s a delightful experience, to wake up to the sound of happy people! It’s something that doesn’t happen at home—if I do wake up it’s to the sound of a snoring Portuguese Water Dog stretched out beside my bed.

Some patients here never laugh: I suspect they are the ones who have never laughed in their lives. Petunia (I made up that name) is one. She does smile, but it’s one of those automatic face-arranging gestures which says “I must be pleasant to the riff-raff around me”. In no way does her smile indicate genuine happiness and fun. Nor is she recovering quickly: she’s been here over two months and nurses her pain like a favorite child.

Each of us must embark on recovery in our own way, fighting our private battles and embracing what works for us. Petunia embraces pain—it insulates her from returning to the ‘real’ world. Howard, on the other hand, needs enablers: he’s the one who shouts “Nurse! Nurse!” and then in a pitiful voice whines, “Can somebody please help me?” This morning outside the dining room, he tried this technique to get back to his room. One of the aides said, “Just roll your chair down the hall to your room, Howard.” His reply: “I have to do this by myself?” Yes, Howard, you do.

Bob sings, Ed talks and analyzes, Roseanne paints, I write blogs.  In our individual ways, we are traveling our private healing paths. And as coach and author Judith Cornell suggests, laughter really is our best companion.

laughing_buddha.jpg

 

 

The Newcomers

boat-cartoon.jpg

These days Orchard Creek is alive with the sound of …..patients! Some come in chariots: white ambulances with orange stripes and light bars. Others slip quietly through the door and announce themselves. New patients are a good thing: staff here has been bored, and income is down, and it’s been way too quiet.

But rapidly over the last three days, new ones are coming. The dining room is beginning to fill up and wheelchair congestion is a matter of course. I try to get the dining room early so I have a clear shot at my table without any spoke-to-spoke face offs with someone as wheelchair bound as but with considerably less navigational dexterity.

I am self-sufficient enough that increased demand on the nursing staff doesn’t affect me much, though I still can’t figure out how to make a bed with only one leg to stand on. I am much more interested in figuring out who the newcomers are and what their story is, as much as I can know. Everyone here is very respecting of privacy, so many of my encounters are very surface—it’s like an AA meeting without dependency on alcohol.

“Hi. I’m Roseanne.” The lovely older woman introduces herself, and I am immediately captivated by her upswept hairdo, and her low, cultured voice. We become friends: I discover that she is a watercolorist who lives in an artsy little town not far from here. She is also a retired teacher, single now, and happily living alone in her renovated older home with a new studio room with skylights. But she falls—often and sometimes quite disastrously. Her children have put her at Orchard Creek because they are concerned about her and she fears they will not let her return to her beloved home and studio.

Roseanne and I are seated at the same table in the dining room, and have good conversations during our meals. But we are not alone for many meals: here comes Ed! Ed is another matter altogether—where Roseanne is quiet and dignified, Ed is robust, energetic, and a talker. And Ed has plenty to talk about—his store of facts and stories seems endless and I, somewhat a doubter when anyone talks that much and seems to know that much, reserve judgment until I realize that Ed really does know all he is talking about.

Our dinner table is more animated and fun now. Ed has had heart surgery, and is at OC to gain strength and take advantage of the excellent physical therapy offered here. His politics are quite liberal, and he makes no effort to suppress his thoughts—Roseanne and I decide that if the other residents in the dining hall could hear better, they would probably be most offended!

Ed and Roseanne are the same age, and grew up in farming communities not far from each other. As they discover these areas of like experiences, I am treated to some interesting and colorful memories of the world as it was in a Michigan farm town some 70+ years ago. We talk about cows (Roseanne’s job was to bring them in for milking), and transportation (Ed thunders, “They had better public transportation systems back then than they do now!”). I learn about entertainment (5 cent movies, says Ed, the film buff) and recipes (“There’s nothing better than a loaf of homemade bread and a bowl of soup from the week’s leftovers”, says Roseanne.)

A day or so later, Irene joins us, adding another layer to the conversation. Irene watches educational TV, reads a lot of books, and knows in detail the history of Benzie County, where she was born and raised. She too is an expert on long ago—food, child raising, education: nothing much escapes her. Though she is quiet, when she speaks, we all listen. She was quite depressed when we first met: she didn’t have the strength she felt she should have, after her stroke.

It feels like our dining table is a shelter in the storm. The three others boost my mood by their understanding of my plight, trapped here and getting most anxious for the surgery that is coming. Ed has found some listeners for his monologues, and Roseanne says, “Oh, Ed, you know so MUCH.” Ed puffs up a little, and launches into a new story. Roseanne is anxious about her future and fears it, and Irene is uncertain about her recovery and we all discuss and support her physical therapy progress.

It took Ed a couple of days to find us. He stayed in his room at the other end of the hall, figuring he was in a place with some real loonies. He ate alone and quietly read his magazines, until the staff convinced him to meet Roseanne and me. He checked us out first before committing to sit at our table, but now I notice he’s in the dining hall early, and stays late.

Granted, Ed had a few things to worry about. Down at his end of the hall are some unique characters: one who spends the night yelling “Nurse! Nurse!” loudly, and then asking the respondent to scratch his back or adjust the pillows. He’s a pretty high maintenance guy, so you can hear his commands almost without ceasing all night and all through the meals.

His grumpy and demanding presence is offset by Bob. Bob is a round, smiley-faced elf, with rosy cheeks and a shiny bald head. Now here’s Bob’s habit: he sings! Constantly. He doesn’t remember words very often, so he sings spirited melodies using ‘la la la laaaa’. Fortunately he has good rhythm and infallible pitch: he says he was a singer as a young man, and I believe it. One of his favorite things is to sing during physical therapy, tunes which complement the exercise he is doing. One other thing about Bob—he can sing in a normal male voice, or in a penetrating high falsetto. And he can switch between the two seamlessly.

Here we are, passengers in the same boat. Our future is uncertain—this is a facility for transients, people who are on their way to a daughter’s house, to a home, to a healthier life, or to a more devastating illness. It’s not easy for any of us. Perhaps we need to take a lesson from Bob—smile broadly and sing gloriously.

 

 

I Can’t Go Home Again

snowy-trees-square-bw.jpg

I went home the other day for about 3 hours. My son Jonathan insisted that it would be ‘just the thing, Mom’ and he offered the services of his wife to drive me there and back.

It’s not a long drive—about 2 miles down the road from OC, but that day it was snowy and cold. I keep my driveway plowed and the cleaning lady employed, and of course the UPS driver delivering my online purchases is always welcome! We pulled into my driveway, across the little bridge over the creek, and up to my house, navigating easily through pristine white snow.

Lisa pushed my wheelchair up the newly installed ramp and I navigated up the step and into the house—and there I was! Home! The familiar surroundings wrapped themselves around me, and I was delighted by the new ones: the fancy step-in shower and the new temperature controls that came with the furnace. My cat, Punkin, always the lover, was happy beyond purrs. She scolded me for my absence, and I replied that it wasn’t my fault—I didn’t CHOOSE to go away for weeks and weeks, and were it not for Medicare’s ridiculous insurance programs, I would be home now.

 

Clearly, she didn’t understand that, and neither do I.

 

I spent my time retrieving my tax information from my computer so I could fill out the forms back at Orchard Creek, and once again I wondered how sick people survive without a secretary. Then I sat in my wheelchair looking out at the woods and the lace of snowy tree branches. I held my cat, who had now forgiven me for deserting her, and purred loudly. I tried to reassure her that I would be gone for quite some time again, but that she would have visitors and be well provided for.

 

I returned back to Orchard Creek and my room with the parrots and tropical fish and palm trees, the welcoming smell of dinner, and the blaring tv’s up and down the hall. It was a warm and familiar feeling to be back here, and I welcomed it. Best not to think about my lovely cottage, and my affectionate cat, and my orchids which deserve better care. Best not to think of my two Portuguese Water Dogs, stuck in the kennel. I can’t make going home come true, and I refuse to feed the feelings of loss and estrangement that I felt while sitting at home staring at the beautiful snow.

About Boredom

boredom.png

I can’t imagine what it must be like, having nothing to do with your time. I watch the people around me here at Orchard Creek and I see so many folks who have nothing to do all day—just nothing except eating and working with the Physical Therapy Po-lice. Some of them do get pretty crafty about avoiding their PT appointments, which shows a spark of life:

PT: Would you like to do physical therapy today? (granted, this is not a genuine question. “You VILL take physical therapy so give up now and come along” is what she really means).

Patient: No, not today. (“Never! So get outta my room” is what he really means).

PT: Oh, come on now, Henry. Physical Therapy will make you better and then you can go home! (Smiling. This is the Ultimate Threat for most of the patients).

Patient: I know that. You keep telling me that. But I didn’t sleep last night, and I need my rest.

PT: You can rest this afternoon. A workout will be just the thing you need to wake yourself up this morning. Why don’t you get in your wheelchair and I will push you to the Physical Therapy room?

Patient: closes eyes, slows breathing, and lies perfectly motionless.

PT: Leaves. But she VILL be back, I can guarantee it!

Meanwhile our patient does doze off—after all, he’s been awake since 6 AM, staring at the TV, watching FOX news. But he’ll get up for lunch, which is the next exciting thing.

So there you are: the number one preoccupation is food. Breakfast is at 8, Lunch at noon, dinner at 5PM and evening snack cart at 7:30. In between meal times, there’s television and more television, despite OC’s best efforts to provide Bingo, Bridge, and Beauticians.

Me? I don’t do any of the three “B’s”. I spend lots of time on my computer surfing and working. Right now I have a client for whom I am constructing an online course on leadership—a really fun assignment. I write in the blog. I do origami (not very well) from the beginner’s kit a friend brought me, and I will figure out how to fold The Crane. And the PT people gave me some magic markers and a coloring book of Oriental designs taken from the actual embroidery on robes and formal gowns. (I am supposed to color in therapy in order to entertain me while I practice standing on one leg. Try it—it’s not easy).

And finally, there are friends and family who visit and bring gossip and presents. They don’t scold me, like my neighbor’s daughter does her mother (“Mom! They tell me you won’t eat your oatmeal! Mom! You don’t use your walker to go to lunch. If your ankle hurts we’ll get it fixed—you NEED your exercise. Mom! Why are you wearing that red sweatshirt? It’s got splashes of garage paint on it! Mom! What’s this $4.00 charge? You sent WHAT? Valentines to the staff? You’ve got to be careful with your money, you know.)

Yes, I do listen to a fair number of conversations, too. It’s hard not to, when you have a facility of mostly hearing-impaired people who leave their room doors open. And it’s also due to the fact that I’m interested in how my companions are coping with their lives and with the questions of “Where will I live when I get out of here? My children don’t want me to stay in my house alone anymore.” “Will I ever be able to drive again?” “How can I get my taxes done, all my records are at home.” “Will Medicare cover my drugs if I go home?”

How are the residents at Orchard Creek confronting these problems? That’s the fascinating part for me. Orchard Creek is a microcosm of people, from the residents to the caregivers and professionals. Some haven’t the energy to answer these questions, or to ward off offensive relatives and visitors. And a great many of them have no skills to invite anything but numbing boredom into their lives.

How sad.

Valentine’s Day at Orchard Creek

threesome.jpg

From the very first 5 AM wakeup call, we knew it was a special day. I have made the morning staff well aware of my love of a cup of coffee first thing, so my entry into today was greatly enhanced by a steaming cup of the wonderful stuff.

It was lunch time when we really felt special: at the end of lunch Patty , the facility administrator, and the Orchard Creek owner/developer came to our dining hall. In the first photo, the two men in tuxes are Dale and Rick, and they were carrying with them armloads of long stemmed red roses. They went around the dining hall, giving each resident a rose and a personal greeting, remembering our names! How could we not be delighted?

Patty, now, was another matter—you have met her earlier in my blog and seen her picture. Today, she made herself a cupid for this event. She wore blinking earrings and wings, and carried a bow and some arrows in her quiver. Later she came to my room, shot me with a stuffed fabric arrow that said “Only You” and presented me with a bag of candy and a valentine.

patty4.jpg

Patty, as you have guessed, loves holidays and she’s determined to make even the grumpiest of us enjoy them too. Everything she wore was handmade and clever, and—she made this visit on her day off!

Paul (Lynn’s S.O.) brought me a balloon bouquet, so now my room is filled with helium balloons, flowers, palm trees and parrots. My son’s wife, Lisa the Supernurse, brought me divine chocolates from the new chocolate shop in Traverse City, and my daughter sent me a large bouquet of sugar cookies on stems . And of course, scattered everywhere are cards and other gifts gifts from my friends. Nothing serious about where I am living here at Orchard Creek! My room is filled with color and glitter and good books waiting to be read.

I am preparing to go to bed now: I will leave a light on so I can be comforted by these treasures. I will read a good book and not think about my health or my finances. As Oscar Wilde said: “One should sympathize with the joy, the beauty, the color of life-the less said about life’s sores the better.”

Money and Love

valentinesmoney.jpg

The next hit I am taking is not medical—it’s financial. I had hoped to leave Orchard Creek by Friday, and the staff here was scurrying around, trying to get prescriptions ordered and home health care arranged. I am feeling much better, and I was feeling guilty taking up a room at OC, when I could basically take care of myself, except for the antibiotic IV feed. The therapy staff was ordering a wheelchair and a few other things I would need, and I was feeling like this was a good choice—I love my house, I could do my income tax, and I could retrieve my dogs from Canine Camp (Diana’s boarding kennel).

But then, suddenly, Beth the Social Worker at OC, was standing in my doorway, her blue eyes wide and slightly teary. “I thought I’d better talk to you before I go any further,” she said. “This is not particularly good news.”

“Let me have it,” I said.

And then she told me: Medicare would not pay for the antibiotic and the equipment to administer it, if I received it at home. I would be personally responsible for that cost, which would likely be in excess of $4,000 before much time had elapsed and I could go back to Munson for the hip replacement.

I called Munson to corroborate this news, and the woman there was most helpful and thorough in explaining the Medicare “gap” and its effect on my pocket book. “However, if you get the meds while at Orchard Creek, Medicare will continue to pay until you have utilized your allotted number of days.”

“You mean, Medicare will pay for my medicine, bed, board and physical therapy if I am at Orchard Creek, but not for the meds and pump if I am at home? One is going to cost significantly more than the other.”

“That’s it in a nutshell,” said Sharon of the pleasant voice.

“Well, phooey (not the exact word I used, as I recall), I guess that makes the choice rather easy. You are recommending that I stay at Orchard Creek, right?’

“Oh, I can’t RECOMMEND anything,” she replied. “But if it were MY mother, that’s what I’d tell her.”

Now you may recall, Dear Reader, that I previously mentioned that I hired a carpenter to put in a wheelchair ramp and a step-in shower—that project is all finished. But on Monday, Delightful Don the builder called to inform me that the heat wasn’t on in my house, though the thermostat was set at 60 degrees. The bottom line: a new furnace, which is being installed even as we speak. And of course if you live in an area where the temperature hasn’t been above 30 degrees F. since shortly after Christmas, heating is a necessity. So I’d already spent in excess of what my Medicare bill was going to be…making the extension of my stay at OC a no-brainer.

Again, nothing here that could be prevented, and there’s nothing to rage about. In my new-found skill of conserving my personal resources and applying them to a healthier body, I am not fighting this battle. To begin with, to fight would be like banging my head against the Great Wall of China. My other reason for sharing this story is to point out that the decisions I see in progress every day by the residents of Orchard Creek are not just about health, or age, or whether the cook can cook. These decisions are also about financial resources. Marion, my friend who moved into an extended care apartment here at OC so she could be near her husband (also at OC) gasped when she saw her month’s rent that her children would have to pay. For several weeks Irene and her single-parenting daughter have been searching for a rental which they can afford. And here at OC, valentines with a piece of candy are available to give tomorrow for the grand total of $.25 each (or one card from your bingo winnings).

It’s remarkable, I think, that the OC Valentine Store is doing such a brisk business. The $.25 is pretty dear for most of the OC residents, but everyone seems to want to say ‘thank you for caring about me—I care about you’, I am learning this lesson: Money isn’t everything, even if I can’t go home just yet.