Sometimes you have to speak up

My brother got a call yesterday from my rehab place, inviting him to a care plan meeting next week for me. Problem is that I’m my own power of attorney and no one had invited ME to the meeting. In fact, no one had told me much of anything about how this practical end of things actually worked here. I’d never met the social worker or had anyone explain about care plan meetings or even care plans. None of the others on my hall had those, either. Even simple things like how laundry gets done were never explained. This is not okay, and I was not happy. Not about the laundry but about meetings to plan MY care with my emergency contact invited but not me. So I spoke up.

I spent large parts of my working life dealing with high level problems involving staff, budgets, systems, and/or materials, and many hours of that time were spent talking with people who left things unsaid or undone. The key is to keep calm, be clear, not get personal, and have your facts in order. If I could deal with Thompson West, I could deal with Meadow Lake.

I found the Director of Nursing to ask what was going on, who was this person and how could I meet her, and what was the care plan meeting about. And was there an expectation that I would be terminated as a patient here when my 30 day initial stay was completed. I also cornered, er, discussed this with my physical therapist. I was still not happy.

Then someone called an MDS Coordinator came to my room to see me. Apparently she is important and the one who oversees these things, as well as the social worker. I’m all for turning difficult situations into teachable moments, and this situation provided one to explain the obvious point that you check with the patient before you call the family. I had a chance to explain what my concerns were, and I got an apology right out of the gate.

I’m comfortable now with a care plan meeting next week that will result in some extended time beyond the initial 30 days; the company that owns Meadow Lake requires that each admitted patient have an estimated discharge date, which can and is adjusted depending on progress. Although I was admitted with a 30 day estimate, that will change with reports from therapy about their goals and plan for my progress. I probably will not need to stay until November 1st, but I’m also not going to be ready to go on October 1st. Somewhere in the middle.

My brother doesn’t have to come up for that 20 minute meeting. That’s just silly and a poor use of his time, since I can and will speak up on my own behalf.

Finding a Kindred Spirit

Rehab is a pretty boring place most of the time. Actually, it can be depressing. Therapy only takes up a sliver of the time and for the rest of it, we’re on our own. We’re not all engaged at the same level depending on why we’re here in the first place. Not everyone is able to talk much if at all – and you know me, I’ll talk to a rock. What’s wrong with me is below the waist, not above, so my ability to think and talk and engage is pretty high.

I found a kindred spirit in Charlotte at my last rehab place and having someone to talk to over meals and to encourage one another in therapy made a huge difference. I’ve found that person here in Jan, who also had spine surgery but ended up with post-op problems with one of her legs. We’ve laughed ourselves silly the last two days, and go for rolling rambles in our wheelchairs. We’re almost the same age, have very different life experiences, but both have wicked senses of humor that are helping us deal with some of the weirdness we see every day.

I didn’t do any walking today because the AFO Velcro problem was reported to PT but not fixed. Grrrrrr. Because it’s not safe to walk any distance without this being repaired, my PT time was cut short – and OT never happened. We don’t know why and it blew apart the afternoon, which I’d planned around a 3:30 OT session. On the other hand, I had another night of being able to lift the legs up into the bed, even for an 11pm trip to the loo.

I mentioned to Jan that it’s my job to be able to direct my care, which I’ve mentioned here before. She hadn’t heard that and wasn’t sure what it meant, but as I explained that it required me to understand what I wanted to do and how I wanted to accomplish it, and then being able to explain that to the people who were there to help, she realized that she wasn’t doing that. I think she’s going to try. Every day I realize more and more how fortunate I was to have those three weeks at the Olympic Center with one-to-one dedicated therapists, and specific nurses and aides to help me. I learned sooooo much that put me ahead here.

It lifts my spirits to hear from you friends and family near and far, to know I’m not forgotten while I’m here in this different place. Your prayers and cards, visits and calls and surprises help me be grounded and remember that I’m not really alone. God is here with me as I slog through this valley, and I will get through, with His help and yours.

Cleaning Up the Family Tree

I know, I know … no new profiles recently. But I’ve been working like a fiend behind the scenes doing database cleanup on my 48 year old genealogy files. I have public trees in several places including Ancestry.com, but my real work happens in FamilyTreeMaker (FTM), which I’ve used since it was a DOS program (yes, I’m old and have been doing this a long time). I’ve also been synching my tree between Ancestry and FTM since the capability was offered, keeping both up to date.

FTM
FamilyTreeMaker Available at https://www.mackiev.com/ftm/index.html

But there are problems. Lots of problems. Importing and merging records over many years gave me a tree full of errors and I hadn’t really done systematic cleanup. I had duplicate names recorded as separate facts, a mishmash of place name formats, and serious errors such as people attached to the wrong parents. Oops.

So that’s what I’m working on now. I joined a Facebook group for FTM Users, which has wonderful resources on working with the software which has developed powerful tools for cleanup that I had no idea were part of the software.  Ancestry doesn’t have them, although I do like their relationship tools better than FTM. Lucky me, I can work in both and synch.

ResolveplacenamesMy trigger for doing all of this was using the new FTM plugin Family Book Creator to pull data from my tree into a book of my father’s ancestors. Looking at the index of place names, individual names, source list, and scanned images gave me a road map of things that need fixing.  I started with the easiest (and smallest) group: duplicate people. Then I worked on reconciling place names, making sure that all elements were present and in the same format of  City, County, State, Country. Although I’ve been careful about this in the last few years, I had decades of old work that needed correction.

Next I went to Manage Facts and was appalled to see that importing records from FindaGrave, Fold3, and Newspapers.com created dozens of new fact labels with data that should have gone into a different field. I worked through these one at a time and have a strategy for working with new finds.

Now I’m working through the Data Errors Report, which had 36 pages of problems such as missing dates, duplicate events, duplicate names, children born when mother was too young or too old, etc.  I can’t fix the “missing date” problems for most of these people right now but I hverified that my extended direct lines are complete and I have a report of what’s missing to work on later.  The other errors are taking time to work through but it’s satisfying to know what needs doing.

DataErrorReport

My biggest challenge ahead is cleaning up my Source list. It must be done and I know why and how, but I hate citations and hate that I have so many to fix, which is why I started with everything else.

Notes to Self About Lapband Issues

This post is really from me to me, to remind me of some lapband issues I’ve encountered recently, and to record a status update.

1.  Hiccups mean that my pouch is full.  When they happen while eating, stop and put down the fork/spoon and put the rest of the meal away for a later meal or snack.  Be sure to wait for 30 minutes to start liquids again or hiccups can pop up if you start drinking too quickly.

2.  First Bite Syndrome is something I’ve just learned about but recognized as an explanation for the throwing up I’ve been doing lately.  I’ve written before about productive burping before and this is sort of a variation on it.  It’s been happening several times a week lately, almost always on a weekday.

Here is a great explanation of what’s happening and how I should handle it:

First bite syndrome is not uncommon. For some reason the esophagus, and therefore our pouch will sometimes spasm, and tighten up when we take the first bite. When it does this, then anything added after will only hurt and cause you to PB.

What is suggested for issues with first bite syndrome is to begin the meal with a couple of sips of a very warm liquid—water, tea, coffee—small sips of it hot! Then take the tiniest bite imaginable—chew well, and wait. Let it hit your pouch and allow the pouch to accept it, after a couple of minutes—serious minutes, as in 120 seconds—not just a few seconds—try another tiny bite. Then wait again.

If after a few bites, you still feel good, then proceed as usual with your meal. If it feels stuck–just stop! Then in a half an hour or so, try some fluid, and stick with fluids for a few hours minimally before you try again. Anytime you end up PB’ing, the best thing for your stomach is to go onto liquids for a period of time, allowing your stomach to settle without causing further swelling.

Source:  From a post by Kat817 on Lapbandtalk.com

I don’t have FBS problems on weekends because I wake up more leisurely (post 5:30 most days) and start the day with a cup of coffee, putting off breakfast (usually yogurt with a little bit of fruit) for at least an hour.  My esophagus/tummy have time to relax.  And I can spread out my breakfast time when I’m not watching the clock to be sure I’m dressed and ready to leave for work no later than 7:20am.

Tomorrow is my first visit with my surgeon in 2 months, and I haven’t had a fill in three months.  He did take some out before that because I really was PB’ing a lot because it was too full.  The band is small (mine holds 10cc) and we haven’t found my “sweet spot” yet.  I’m hungry a lot, which is a sign that I don’t have enough restriction in the band.

I needed to understand the difference between PBs and First Bite Syndrome to be sure I’m ready for another fill, and know how to adjust to make things work better.

I know the nurses (one in particularly is very harsh) will give me grief for having my weight loss slow down during this period even though I did lose 8 lbs.  I’ve been eating more carbs than they would like (they want me at about 40 and I’m eating more like 80-90) but it’s still well below what is considered normal for a balanced diet – and I feel better when I eat some.  Not prepared sweets so much as beans, strawberries, and dairy.  I’m not giving them up.


Status Report:

1.  Nutrition: I’m eating between 1000-1150 calories/day, with approx. 80-90 gms carbs, 40 gms fat, 70-85 gms protein.  Fiber is too low because I’m not eating enough vegetables even though I want them (they don’t stay down well yet).  Cholesterol intake is under 100.

2.  Weight status: 204 lbs down from 310 lbs for 106 lost.  44 lbs to go to my goal of 160.

3. Exercise status:  still low but have started working out with a personal trainer in the pool and on the weight equipment.