Bummer

This blog is turning into a real bummer.  I know.

It was intended to be an upbeat travel page, but since Mike's accident my life has been consumed with daily trips to the hospital, tracking down his bills and paying them out of my own pocket, and meeting with doctors and lawyers.  Some trip.

"Lawyers" ???  Yeah, right, though I surely didn't want to.

There should be no current need for lawyers. There is no fight with the insurance company. They have agreed to pay.  Any lawsuit should be put off until we are beyond their ability to pay - at the limits of the liability policy.  We won't know how bad it gets, or what expenses will be incurred, for maybe a couple of years. There's plenty of time for that stuff later.

And we would certainly be unwise to put Mike's future in the hands of some fly-by-night contingency lawyer, who will try to take 40% off the top.  Combat pay where no combat is needed, and none is offered.

But I am now seeing lawyers.  I have no choice.  There are people trying to take over various aspects of Mike's life while he is incapacitated, and I have to defend him against them.

My contention is that everything should be kept as much as possible just as he left it on October 1st.  That is:  his bills current, his job protected, and his house empty, so that when he recovers he can step back into his life and take up pretty much where he left off.

It has only been 6 weeks.  He should be left alone to recover.  We will know more about the end of this story in a couple of months.  We can reconsider then.  But some people are in a suspiciously great hurry to change things to suit themselves.  It takes considerable expense and effort on my part just to hold the fort.

The good news is that Mike is now in a NeuroRehab hospital.  He is responding to therapy.  He is starting to regain his short term memory, and occasionally tells me "You told me that yesterday".  The other day he recognized somebody from his office while they were still in the doorway, and greeted them by name.  Yesss!!!

He left no power of attorney.  He needs to recover quickly.  If he does not, he could end up broke, disabled, jobless, homeless, and sitting alone at the curb in a rented wheelchair.  Next to the garbage cans.

He deserves better.  I will not let that happen.  But much of it could turn out to be beyond my control.

As for myself, I find that stress makes me stupid.  I know it's maladaptive, but there you are.  I am usually quite capable of keeping several balls in the air at a time, but this is different. Sometimes my skull seems filled with Karo syrup.  Doctors who appear to be about 12 years old can spout information at me, and it takes 3 tries before it fully penetrates.

Information no longer travels at the speed of light.  If it ever did.

The thing is, I know what needs to be done.  In a few hours, I could set up things to be self-paying for the next 6 months.  Little by little, I am getting most of it done, indirectly, by taking a lot on myself.  But Mike didn't leave me any tools to protect him with, other than the force of my personality.  Much of the time I am reduced to grinding gears and stomping my foot on the brake.

My message to you is this:  We all have a date with disability.  It can come at any time.  When it comes, you are going to need someone you can trust to handle your affairs.  Empower them.

If you don't have anyone you can trust, you are already disabled.

Do something about that.  Now.

Bob

Odd Signs Of Hope

A Short History of Medicine


Patient: "I have an ear ache."
Physician:..
2000 B.C. - Here, eat this root.
1000 A.D. - That root is heathen, say this prayer.
1850 A.D. - That prayer is superstition, drink this potion.
1940 A.D. - That potion is snake oil, swallow this pill.
1985 A.D. - That pill is ineffective, take this antibiotic.
2000 A.D. - That antibiotic is artificial.  Here, eat this root.


- Anonymous


Yesterday my brother Mike had what we hope is his final operation due to the motorcycle wreck, to reconstruct his face.  The fractured bones of his cheeks and at his right temple were screwed to small titanium plates.  The operation, by all accounts, went very well.  When I saw him in the ICU afterward, I was surprised at how invisible the procedure was.  The plates under the eyes were inserted from inside the mouth, and only a small suture at his right temple shows where that plate went in.  Perhaps 10 stitches.

His face was not badly swollen.  You cannot see the plates.  She realigned his bite to where his upper and lower teeth met properly.  He has something of a boxer's nose now, with a slight bend to the right.  The surgeon tried to fix that, too,but the problem is in the soft tissue, not the bones.  When she tried to insert a plate there, it showed through the thin skin, so she decided to back off.  Instead he will wear a sort of splint on the outside for a time, to see if the tissue will straighten out that way.  If not, further surgery can correct it when he has healed up from the rest.

I doubt he will bother with it.  He is not that vain.  Or perhaps he is, but in that curious way that sees a few scars and a bent nose as interesting.

One good bit of news:  the attachment to the plates was stiff enough that she did not have to wire his jaws shut as a splint.  He was talking up a storm in the prep room before surgery, answering questions, able to understand where he was and who we were.  It was obviously a strain to be cogent, but he took the strain well.  The principal sign of not being quite together was a tendency to repeat himself several times.  Hell, I do that even on some of my better days.

This was the most he has been present with us since the accident.  I fully expect that in the days to come we will not be able to shut him up, and he will begin to take soft food.

He even blew one nurse a kiss.  I take particular heart from this.

And when another asked him how he felt, he said quite clearly "Not worth a shit."  That's Mike. There's nothing he could have said that would done more to convince me that he was on the mend.

Bob

Give That Guy A Hand!

Every day I go visit my brother Mike in the hospital.  And every day has its ups and downs, but the overall effect is of idling in place.  All the peripheral junk, like bill paying and insurance faxes and disposing of the remains of his motorcycle and cleaning up his house and yard - all that stuff has been taken care of, is being taken care of.

But he can't talk worth a durn.  Only the simplest communication is possible.  "Are you hurting?"  A nod of the head.  "Where are you hurting?"  "Gurgle, gurgle, wha doan yah keh, gurgle, gurgle."  "Okay, okay, just try to relax."  A miserable tired smile, if only from the eyes.

I go for the nurse.

He can see okay out of his left eye.  When asked what he saw out of his right, he said "Chalk". Of course he has a neck collar on, so mostly all he gets to look at is the ceiling.  They are afraid that eye got dried out in the days after the wreck, when he was sedated and his eyes didn't close fully.  Plus the right eye was more swollen.  They now have a patch over it, to keep the lid closed.  They are applying artificial tears, and some sort of ointment.

He has hallucinations.  It may be due to what they call "hospital psychosis", an effect brought on by being drugged, naked, and helpless, not being able to move, never knowing what time it is, being awakened at all hours and never getting any rest, etc.  It may be due to small bruises on both frontal lobes, where his helmet met the pavement.  They seem to be getting better.  There was also some bleeding at the back of his brain, but again it was not severe and is not getting worse, according to the latest cat scan.  The area is beginning to be reabsorbed.

He spent some time the other day picking invisible things out of the air with his good hand.  When I asked what he was doing, he said "Hairs".  Then he started pulling at his tubes and poking at his good eye, so they tied down his hand.  He fights the restraint occasionally, but not violently.  Sometimes he can wiggle his toes on command, and sometimes he doesn't.  He moves around quite a lot, by increments working his way down to the foot of the bed, or getting a leg over the guard rail on the left side.

They come in and reposition him.  "Damn" he says.  I think he would get up and run out the door if he could.  I have the advantage of him there.

He has so much bloody stuff coming up from his lungs and down into his throat from his mouth and nose they can't keep up with it.  And I'm not much good at suctioning, though I suppose I'm better than nothing.  My principal talent is to run get a nurse when he seems to be in unusual distress.

I get lots of practice.

He's not getting worse.  But he doesn't seem to be getting much better in a hurry, either. Supposedly he is scheduled for an operation on his facial fractures next Friday.  But I don't see how they can suction out his throat with his jaws wired shut for weeks afterward.  All that stuff is settled right on his vocal cords, and right above his windpipe.  He could choke at any time, and suck it down into his lungs.

The surgeon and I are going to have a talk about this.

The nurses are better at cleaning him out than I am.  They are not afraid to bring tears to his eyes.  After they get through, he can occasionally make himself well understood.  Yesterday as I was leaving I took his good hand and said "I'll be back tomorrow, Mike."  And clear as a bell he replied:

"Don't have a wreck!"

I had to laugh.  Still do, considering the source.  Whatever else might be injured, his sense of humor is intact.

Bob

Bad News and Good News, etc.

The bad news is that my brother's insurance company, Scott and White, refused to pay for his further care at Seton Hospital, where he was progressing through all the necessary operations, and where we thought he was being well cared for by competent, hard working surgeons and an excellent nursing staff.  The insurance company insisted, on the very eve of plastic surgery on his face, on removing him to a Scott and White facility in Temple, Texas.

His facial surgery has been postponed for 7 to 10 days, "while he recovers and the swelling goes down".

The good news is that his new surgeon has a glitter of confidence about her, which is all I have to go on in this matter, at least in the last couple of days.  And I will say she made a plausible argument for waiting, and gave a good explanation of the procedure.  She will slip small thin titanium plates between his skin and the broken facial bones, and secure them to the fragments.  She says they will be permanent, but will not show.  He should look much the same as before.  There will be two angled pieces under each eye, and another at the left temple.  The rest of his face, in particular his jaw, escaped injury due to the full face helmet.

She says he will only have his jaws wired shut for a couple of weeks after the operation, as a sort of splint to prevent him from moving the healing bones above.  Much better than the 6 weeks the other surgeon mentioned.  The sooner he can talk the better.  I hope to get some information from him before the operation so that I can pay his bills on line.  I can't find anything in the rat's nest of his filing system.  Just a short conversation with him will make long and tedious conversations with his creditors unnecessary.

More good news:  they removed the ventilator tube and brought him up from sedation yesterday for the first time since October 1st.  The only sign we have had that he was still in there for the last week was an occasional squeeze on a finger.  He had a hell of a time clearing his lungs, but seems to have done so.

He started trying to speak Friday, but it was impossible to tell what he was saying at first, as the tube has been rough on his throat and vocal cords.  He was able to respond to simple verbal commands.  They are feeding him through a tube in his stomach because he is unable to swallow without choking.  There is a continual drip of blood to the back of his throat, and I have learned to suction this.  He is able to purse his lips and bring it forward.

I explained his situation to him in simple terms, but more out of hope than conviction that he understands.  Then today he was able to get out a coherent word or two.  As I was leaving for the day, he clearly said "Goodbye, brother."

That gave me a lift.

Another lift came from a late phone call from the insurance company representing the other party in the wreck.  They have accepted responsibility in behalf of their client, and have asked for an itemized hospital bill to date.  There may not be enough money in the world to pay for all his operations, but at least somebody else will be making a stab at it.  The practical effect for us is that Mike will not have to make the 20% deductible.  Even that is apt to be a sizable sum.

The bad news is that there is probably a limit of liability on the policy.  In that short conversation I did not ask the agent what that limit might be.

The bad news is that I have heard rumors that they might move him out of ICU, once again, before the operation.  I can't escape the feeling that it can't be good to be passed from one set of hands to another so often.  Something is bound to slip through the cracks.

O, and the good news is that apparently his neighbors like him.  They have volunteered to mow his lawn and clean up his house next week.  Bless 'em.

Bob, trying to keep up.