"Hate" is not a strong enough word.
You can die from constipation. (Spoiler: No one died.) Part 4
(Cont.)
My quiet time was cut short when I realized it was almost midnight and I had one more thing to do.
I Googled the county 911 supervisor’s number and called. I explained what happened earlier in the day, complained that the dispatcher emotionally escalated the call, asked how I should go about getting a copy of the transcript or an actual copy of the recording, and rang off after the supervisor refused to give me his name or any other identifier to which I could refer if need be at a later time.
The next morning, I was awakened by a flood of Tr*mp campaign messages hitting my cell phone. The same phone from which I made the initial 911 call, and the phone from which I contacted the 911 supervisor to complain. Advertisements, fundraising links, and polls. Neither my wife nor I freely share our cell numbers with businesses of any kind, not public services, not doctor’s offices, or anything “official.” Nothing public. Our personal cell phones are for personal contacts, only. We block unknown numbers like ninjas. If my cell rings, I can feel confident that it’s ringing for someone I know. My wife and I keep a landline with a silenced ringer to receive all other calls and to make all other calls, and it’s the one we share when a phone number is “mandatory.” We rarely answer it, and—unless a parent is in the hospital—we normally mass delete everything regularly. The silent landline does the lord’s work in today’s age of intrusive advertising and instant gratification. Our mental and emotional health is worth the throwaway price. When the 911 dispatcher baited me into giving him my name and phone number, I gave my cell because I knew he could see it on his caller ID. And, in hindsight, I assumed the 911 supervisor could see the same. In the past I’ve called 911 for my parents from their line, which has kept my cell number chaste.
Instantly, I wondered if the 911 dispatcher a day earlier demanded my personal information and lied about it being legally mandatory so he could sign me up for political garbage. Maybe not personal, but maybe his own version of helping to boost a campaign. Not completely out of the question… considering where we live and the way people behave where we are. I mulled over a mental replay of the 911 dispatcher’s insistence for unnecessary information, his satisfaction with my meltdown, and his smugness in receiving confirmation of my personal name and number. Coincidence or design, I couldn’t say for sure, but the suspicion was there. The ads, links, and polls continued throughout the day, and—as an othered person—each delivery truly did feel like an instance of emotional violence.
Meanwhile, leaving my parents’ house for the hospital, I was pleased to notice my parents’ white male red hat(e) neighbor was M.I.A. for his usual morning harassment session. He wasn’t waiting for me by his bow window, didn’t come outside to yell “Tr*mp’s number one” or wave an american flag in my direction. His front door was shut and every curtain and blind on every window facing my parents’ house was closed. I hoped I could count on his withdraw for many days to come, and not that his sudden “disappearance” was a fleeting reaction in which he might regroup and restart his rabid political harassment anew, with “better” hijinx.
Later in the day, one of my parents’ aides called me to give an update on my mother, and we talked about what I did to the white male red hat(e) neighbor. I was honest. Two things are always sure with me: 1) I won’t say anything about someone that I can’t say to them; and, 2) If I’m bold enough to do a thing, I’m bold enough to admit it in detail later. Depending on the situation—if I am the instigator (which rarely-to-never happens)—I take responsibility quickly and accept easily the repercussions of my behavior. If I am the victim and behaving reactively, this is not true. (This mechanical “structure” of mine often makes me wonder if I’m on the spectrum.) Anyway, my mother’s aide didn’t admonish me when I “confessed” to being vile with the white male red hat(e) neighbor, but laughed and thanked me, because he was “suspiciously,” atypically absent for her, too. We rang off in time for me to arrive at my father’s hospital room.
I found him sleeping, unable to be awakened, drooling, hypoxic, and hypotensive. In reading his records with the nurse, I noted that his pulse ox and blood pressure weren’t higher than 80% and 93/54 for the prior 24-hours. Reviewing his medication list, I found two glaring issues.
On admission, I clearly stated that my father’s “atypical Parkinsonism” was complicated by autonomic dysfunction. I also clearly stated—in writing—that he should not receive blood pressure medication. It’s contraindicated for Parkinson’s patients, and especially for PD patients with autonomic dysfunction. Blood pressure meds can kill them. But, I also know that hospitals subscribe to “blanket protocols” in an effort to prevent lawsuits, and will administer medications without considering the individual, then defend accusations of malpractice by citing “procedure and process,” by hiding behind “standard guidance,” by shielding themselves with “policy.” As well, I know america is experiencing a dearth of geriatricians, so elderly patients are often most endangered by “blanket protocols.” My dad was given BP meds.
I also clearly stated my awareness that laxatives are implicated in kidney failure, and that my father has kidney disease. So, if his constipation clean out should require heavy doses of laxatives, I suggested they be administered in staggered time frames with intravenous fluids. As laxatives such as Miralax and Peri-/Colace are osmotics, they pull water from the body into the intestines, and quickly dehydrate users, exacerbating poor kidney function in people with kidney disease, and causing acute kidney injuries in people who are healthy. This, for anyone, effects blood pressure, but more so for people suffering kidney disease, any stage. Add, for a PD patient with autonomic dysfunction, being dehydrated can cause system crashes. My dad was given Miralax in tandem with Colace, in large quantities, with no hydration. I asked—knowing the answer—if these could be factors in his low function. While the attending attempted to skirt my questions, my father’s nurse stepped up and asked that BP meds be removed from his list, that the laxatives be suspended, and that he receive a saline drip.
If you know a nurse, tell him or her that you appreciate them and are thankful for them. They really do run interference, correct mistakes, and save hospitals and families from devastating consequences. They should be treated better than they are, but… I digress, and will save that “rant” for another post.
Why bother with all of this, you might ask? Why keep my father alive in such terrible condition if death might be more kind? If death would be a better option for someone suffering such extreme health issues, someone who isn’t capable of functioning on his own, someone whose quality of life is poor? Because no doctor so far has indicated that my father should be placed on hospice, or said that he is dying. Despite me asking bluntly, “Is my father dying?” and “Will you tell me when it’s time to place my father on hospice?” no one has answered me plainly or offered this care option. If anyone were to tell me that he is dying, that my father should be made comfortable to his end, that there’s nothing more anyone can do for him, I would follow their direction. If I make this decision on my own, I know I’ll look back on this time and think of myself as a murderer, and that’s not a line I’m willing to cross.
Sure, I’ve put to “sleep” two cats and two dogs. I’ll eventually put to “sleep” the two cats who live with my wife and I now. But, their veterinarians have always been honest and upfront about our furbabies health and timelines. Our “childrens’” doctors have always told us when it was time. Someone else with more capacity than me has released me from doubt. I wish more medical doctors were up front about patient health and survivability. I wish more medical doctors weren’t bent on whether they could keep a patient alive, and instead considered if they should.
Having sorted my father’s care, I headed back to my parents’ house to tend my mother, knowing the aide should have taken leave. When I walked in the door, my mother greeted me with glassy eyes, slurred speech, and slight delirium. I called my wife, immediately.
“Heeey… wha’cha doin’?” I asked.
“Working. Who needs what?” she asked.
“Will you take mom to Patient First. I’m betting she has a UTI.”
“AGAIN?!?!” my wife groaned. “Let me check my meetings, I’ll be there as soon as possible.”
Within the hour, my wife texted me for a list of symptoms to share with the doctor at the walk-in clinic.
I sent, “frequent urination, peeing her pants more often. complaints of lower back pain, chills, and nausea. lack of appetite with intense sugar cravings (jelly and soda), and chewing louder than normal. sleeping more throughout the day, instability walking, intensely turtle-like movement, complaints of blurry vision and having glassy eyes. hoarding, laughing inappropriately, disorientation, ‘word salad’ and slurring. emotionally demanding and increasing tantrums/attention-seeking. water avoidance, refusing to drink and bathe, refusing to change her clothing. suspicion and paranoia… need more?”
“Nope. The doctor’s ordering a urine and labs.”
An hour later my wife texted, “UTI confirmed. Antibiotics. She’s upset, acting like a petulant child. Progressed to metabolic encephalopathy. Explains the batshit craziness.”
Two sick at once. Something we experience often.
“Meet you at their house,” I wrote back.
I’d driven to the post office and bank to run errands while my wife handled my mother’s medical issue. On the way into my parents’ neighborhood, I recognized someone with whom I enjoy talking. So, I stopped. The elderly gentleman was outside with his dog. We chatted over all his latest medical updates and all my parents’ latest medical issues. Then, he asked, “What do you think of that Spanish family on your parents’ street?”
Taken aback, I asked, “The family in the green house?”
“Yeah,” he snarled.
“I don’t think anything of them. They live there. They keep to themselves. I like people who mind their own business. Why? What do you think of the family?”
“I don’t like them. They play their loud Spanish music all hours of the day and night. I can hear it all the time, and I just hate it.”
“It sounds like this is stressing you out. You want silence, especially at night when you’re trying to rest,” he nodded while I clumsily attempted to validate him. I don’t do this well, because… I feel uncomfortable assuming how other people feel. And, frankly, if someone were playing their music so loudly that I could hear it in my home, I’d wear noise cancelling headphones and be done with the bother. I wouldn’t allow myself enough time with the annoyance to feel anything about it. “Did you approach them to ask if they’re willing to turn it down? Or, did you call the police to report a noise ordinance violation if it’s happening late at night, after hours?”
“No, I don’t want to bother with them. I’m just gonna vote for Tr*mp so he’ll send them back to where ever they came from!” He said, matter-of-factly.
I was so taken aback by this man’s warped logic, I couldn’t speak. He was always so welcoming of strangers, all strangers. He talked to everyone, no matter their primary language, their appearance, their origin, their orientation. In every conversation I’ve had with him over years, he seemed logical and reasonable. But, he had several heart attacks in the previous year, and he was on several new medications, so I wondered if these were responsible for the disturbing change in him.
Few people realize that health events can leave lasting effects on brain function, or that commonly prescribed medications can, too. Viagra is a great example of a harmful “good.” Viagra is know to cause psychosis, known to induce aggression, known to be a factor in neurological changes. Studies differ in the incidence of these side-effects, but they’re known. When any man behaves like a jackass, I often wonder if he’s taking Viagra, whether for sexual dysfunction or for pulmonary hypertension, jet lag, as an athletic performance enhancer, or some other off-label use. I refrained from asking whether this was the case.
“You realize… Tr*mp’s not going to personally send anyone to their house to make those people move, right? Like… you know they’re citizens,” I asked.
“How can they be?” He boomed. “They don’t act like Americans!”
“My g-d, man. Have you lost your mind?” I exploded. “What does an american act like? How do we act? Do you know, to the rest of the world, we’re disgusting? We think like uneducated morons. We dress like slobs. We act like buffoons. We’re untrustworthy and destructive, selfish and piggish if you go by what people in other countries think of us. So, what do YOU mean when you say they don’t act like americans?”
He stood staring at me, saying nothing, so I went on. “Listen. This whole ‘make america great again’ bullshit is just that… bullshit. I don’t want to go back to any time in this country’s past. I’m not saying that you’re stupid, but what you just said as a justification for supporting Tr*mp was stupid. Those people are citizens, and even if some people in their family aren’t… that’s none of our business. They’re here, and they’re our neighbors. They belong to us and with us now. And, I have to stop talking to you about this, or I’m going to say something I’ll regret. I like you, but I absolutely do not like what you said. How dare you? Just… how dare you?”
“I didn’t think of it that way,” he said. “I feel like… if they’re here… they should act like they’re not the only people in the neighborhood.”
“Cool. I can agree with that,” I shared. “Do you need a solution? I’ll go knock on their door and ask them to lower their music for you. Just know… you’d be sending a girl 20-years younger than you to do your own job. But, for you, I’ll do it. I’ll even go with you if you want.”
“Let me think about it,” he said, looking sheepish. I had no way of knowing if his response was from my reaction, from a genuine shift in thought, if he was feeling uncomfortable with the confrontation, or anything else.
“Hey there, neighbors!” came a different voice apart from us. It was another familiar person, a younger woman who often walked her dog and stopped to chat. “I want you to know, I saw the brown TNR tabby.”
“GET THE FUCK OUTTA HERE! I’M SO RELIEVED!! Thank you, thank you, thank you!” I gushed. “I haven’t seen her in more than two weeks, and I’ve been so worried.”
“Well, she looks skinny, and she’s skittish. She’s been under my porch. She doesn’t come out much, except to eat and drink. I give her food and water. I can’t tell if she’s sick or not.”
“Hey, if you’re able to get close to her, and you can catch her, I’ll take her to the vet.”
“Deal.”
(To be cont.)