Surprises 2

Thursday morning I rediscovered that a little paranoia can be a good thing. It all depends on what you are paranoid about, of course, and what you do with it.

I was switching over Daddy's Oxygen lines from the bedroom line to the living room line in preparation for moving him down the hall in the morning. After plugging the new line in, I put the cannula portion next to my ear to make sure I can hear the O2 flowing. That's the part I'm paranoid about.

Nothing. Nada. Zip. Not even a whisper.

Oh oh!

So I plug back in the old line, let Daddy know what's going on, and go wake up Richard to try to find out what's going on. I'd do it myself, but it involves lots of knee work, and he's only got one bad knee. After about ten minutes of grunting, groaning, and swearing (him, not me), the problem is located. It's not a crimp. That much I had determined myself as well as I could. It's a hole in the line, a nice angled V slice through it, pouring out the oxygen onto the floor, a place where it's not quite as well appreciated as it would be pouring out the cannula.

Some times it's nice to be a little bit of a pack rat. After he'd been on O2 for over a year, the company supplying the rental equipment mentioned that the tubing parts should be replaced monthly. Oh, gee, thanks. So we got new cannulas and new 50' tubing. We'd prefer something shorter, but 25' is the only other option, and that's too short. So, we use the 50' and push the machine up to 4 to overcome friction and make sure there's actually pressure in the line by the time it reaches his nose. But we saved the "perfectly good" piece of old tubing when we made the swap, "just in case."

Here was the case. Six months later and here was a need to swap out his tubing again. Of course, why replace perfectly good tubing just because the calendar said to? Or just because Medicare will pay for it? Holes, now, are a different thing.

We speculated that this had actually started at least the afternoon before, when Randi measured his sitting blood O2 level at 71. Nobody had thought to check the equipment. It may have even been a minor problem before that, a tiny hole that grew with rubbing and tugging. It seems that a screw at the bottom of my chair was sharp enough to have caused the tear. It was the only likely culprit near the site of the tear.

After setting Daddy up for the day, I rushed off to work. This had put me half an hour later than my usual late. Richard promised he would cover the screw with duct tape. I promised to order more tubing.

When I called in the order, they asked if we had tubing available. My guess is that had I said no, one of my coworkers would have gotten a nice run up to Shafer from the midway area of St. Paul, one of the local branches of this company. Since we had saved the old tubing, the new got shipped UPS. I figured we'd see it the middle of next week, but it arrived Friday.

Meanwhile Daddy's perking up. When his physical therapist arrived on Saturday, he was joking with her, and working harder than he had been able to. His pre-exercise O2 level was 96! After walking down the hall, he was lightly out of breath, with the O2 dropped to 84, but recovered quickly. Most mornings lately he's been so out of breath in the mornings from the (1-way) walk down that same hall that he lies like a fish gasping for water after it has been caught. Cathy commented that that was as fast as she's seen him complete that walk. She also agreed that the best thing we could have done for him was to park that wheelchair and make him walk.

She was a little surprised at the sense of humor. She hadn't seen it before, and asked if he'd used to be like this? I assured her that he had. I'd seen it just that same morning. He'd finally wakened just after six, and I decided that it was pointless to coax him back to sleep. I might as well get him up and going for the day. I mentioned to him that I had to leave for a bit at one point, because his bed was as far as I'd gotten when I got up. Much needed to be done.

He looked at himself sitting up at the edge of his bed, and commented that his bed was as far as he'd gotten when he got up this morning too.

He's back!

For now, anyway.

Honeymoon Dreams

Steve and I hadn't gotten around to discussing, much less thinking about a honeymoon yet. There's just been too much going on for either of us, and funds will be tight. So tight, that we're thinking of asking the guests to skip the presents (we've both got too much "stuff" already) and turn the reception to a pot luck. Hey, ever price flowers at Valentines Day? Or spaces? But that's called romance.

Anyway, with a winter wedding planned, and me being so sick of winter right now I could almost choke on it, especially with the year's coldest weather imminent, I got to thinking about how nice it would be to escape to Arizona for a bit. RIGHT NOW! Of course I can't, but as a honeymoon?

We both love the state, especially its lack of winter. Yes, I know they have one, but nothing that counts to a Minnesotan. Nobody in Arizona has ever gotten their tongue stuck to a flagpole, or faced a month below freezing, or frozen a banana so hard it can pound nails ( - 13 F. Honest! Demonstration tomorrow morning on KARE 11 by Jonathan Yuhas, meteorologist/weatherman) or had to shovel for six months straight, or gotten frostbite despite sensible clothing. And it's not just the paucity of lakes that keeps them from fishing through tiny holes augered through the ice. Do they even know what windchill means? Or roof raking to prevent ice dams? Or ....

He used to work at the Grand Canyon, and we'd love to spend a night there. He used to live in Flagstaff, and wants to see if the old houses are still there. I'd love to drive him past Wukoki, take him on a tour of the Sonoran Desert Museum's Hummingbird House, and tour the Tombstone cemetery and Karchner Caverns. We both have friends in Sun City West who got smart years ago and escaped Minnesota winters.

We'd have to come up with another scooter by then. Just one won't do. And research the accessibility of most of those places, and find the cheapest air fares, and budget and save and....

But oh, wouldn't it be nice?

Surprises

Not all surprises are good ones. In fact, these days, few are. But not all are bad either.

Take my dad's foot, where he got a burn back around Thanksgiving. We were waiting and watching to see if/when it opened up, something that would need immediate and watchful treatment. Last week the outer layers sluffed off, leaving a patch of pink skin behind. Surprise! So many of his systems are shutting down, but he can still heal his foot?

A surprise to him, once I pointed it out in one of our mostly lucid conversations, is that his nerve-damaged foot has not been feeling cold for a while now. That used to be the hardest thing to try to treat, and in fact is what led to his getting the burn on the other foot (at the hospital). Since we got him those super-thick fleece sweatpants, it hasn't been cold. I had been theorizing that keeping his legs warm would result in keeping the foot warm, since he'd be supplying warmer blood to it. Surprise! It seems to have worked.

Randy got a surprise yesterday on her visit. Even with his oxygen concentrator kicked up to 4+, as it has been since Thanksgiving, his blood O2 levels can still drop precipitously. She finally got to see him when he was non-lucid. (He usually gets more alert for her visits.) Checking his levels, the blood O2 was down to 71. She'd already announced that his lungs were clear, something that - surprise in itself - should have been a good sign. Apparently there's just less working surface there, regardless of how they sound.

She gave us a surprise yesterday. She instructed us to quit adding the Thick-It to his liquids. He hates it and therefore has been drinking less. As a result, he's been getting dehydrated on occasion. Given a choice between aspirating a little liquid and dehydration, the aspiration is the lesser of the two evils. So this morning, soon as I finish posting this, he'll be getting his coffee just the way he likes it. That ought to please him. He's been complaining about it for weeks.

I Hate Winter

It can't be said strongly enough: I HATE WINTER!!!

OK, sure, it can be pretty. For maybe the first twenty minutes after it stops snowing and the trees are covered with pristine white. But only if the light is right - and the camera ready? - and you're sitting warm and still somewhere with a view of it and nowhere you need to go that in any way can be considered "outside". After a bit, white on white on white on white just gets boring. Not just a little bit boring, but Jo Anne Worley singing-out, fingers-in-the-dimples boring.

We were growing a nice crop of icicles on the roof a bit back. Those can be appreciated from inside, but then one has to worry about ice dams, even with the new roof. Those are gone now.

We're in this goofy weather pattern right now where it snows nearly every day, and in between the temperature bottoms out. While it's snowing you get the wonderful experience of flakes sliding down inside your collar and blowing up the inside your ear. You can't see where the ice is under the fluffy stuff you're walking on, or where the bumps are or curb edges, or anything else. So every step is wobbly, throws your legs to all sides so your kneed grind, and risks dumping you to the ground so you can do more damage to your tendons.

We believe in salt here. Halleluia! It's the only thing that keeps walking a semi-sane possibility. It also follows you back into your car to coat car mats and rust out your car floor from the top down, not just the bottom up as the car splashes its way around. A lot of ins and outs during the day leaves salty puddles on the floor which wick up your pants legs and leave a thick, jagged, inch-wide band of salt on the back sides. After two days the bands are so thick they make your pants legs flare out by themselves, and don't completely come out during your water-saving washing cycles.

(Yes, I wear my work pants two days. You got a problem with that?)

Obviously, I drive though this crap called winter. It's not just walking that raises issues.

There are tricks you need to learn to be able to drive through the stuff. For example, while you need to heat your windshield in order to be able to clear the ice and snow off it for visibility, you also need to be able to hit that sweet spot where your windshield cools off without depositing ice so that the new falling snow doesn't melt and stick but just blows past while you drive.

Too much melting also just changes the fluffy stuff to ice that builds up on your wiper blades creating their own wet streaks across your windshield to reduce visibility with each stroke. You see many drivers cope with this by the "thunk" method of ice clearing. Mostly they are stopped while doing this, such as at a light, but I've seen this done in motion. Rolling the driver's window down while the wipers are in motion, they reach out to catch the blade in it nearest approach, quickly lift and release so it goes "thunk" down on the windshield, hopefully thus breaking off the accumulating ice chunks which are causing the problems. Many repetitions may be needed. Eventually even this fails and one must pull over, get out, and break off all the ice and wiggle all parts of the wiper blade to ensure function again.

For a bit.

If it's really cold, sometimes washer fluid, better known as "blue juice", can help melt ice and frost off windshields. Of course, there is always a thin film of residue left that does not evaporate quickly in cold weather, so one is left with a - hopefully short - period when the total windshield is a blur and only the wind can clear it. One develops the skill of staying on the road while this occurs - or one doesn't. In a panic situation, one can quickly reapply blue juice to melt away the film and reinstate visibility, but do be mindful that the situation repeats. It is possible to run out of blue juice trying to cure the problems left by non-evaporation of the previous application.

If it is the first really cold spell of winter, you can ask yourself before you start the squirters if you've remembered to purge the summer half-and-half mix of blue juice with water, replacing it with full strength blue juice. It's one of the reasons to schedule an oil change for late fall. Of course, you have to do the purging on the way to the change, or else they just top it off and your solution is just a tad stronger than it was. The reason this is a problem is that it will freeze when the temperature approaches zero. There you are driving along trying to clear slush and salt and muddy spray off your windshield and all you get is wipers smearing the stuff, taking you from spotty visibility to absolutely none. If you've not made the changeover, do not hit that switch! If you've just made this rookie mistake, well... do you still pray?

If visibility issues are cured, there's the plethora of moving issues.

It's been my observation that there comes a very surprised look over the face of a driver whose vehicle has just gone from moving straight ahead to heading in a 90-degree angle and diving nose first into a snowbank. I passed one such this week. Lucky for me, the snowbank in question was tall enough to keep him from crossing the center median and hitting my car. Lucky for him, traffic behind him was wise enough to keep their distance, enabling him to pull out of the snowbank and back on to the road, hopefully a slower and wiser driver.

But maybe not. Physics isn't taught well in schools these days, it seems. The simple rule that everyone forgets, until winter driving reminds them the hard way, is that in an absence of friction, inertia triumphs. Every single time. No exceptions. Not even for you. All that cold wet stuff provides that absence of friction.

I'm not exempting myself from this lesson. I've managed to knock down a road sign, dent a bumper in a snow/ice bank, slide through a stop sign. And not all in the same incident. I've learned enough times that I'm starting to remember, now. I have no problem with being the slow driver on the road in winter, and am perfectly content with letting those who do have a problem with that pass me in the left lane. (Of course, they tend to kick up lots of snow and dirty slush onto my car as they pass, so I keep the washer fluid and wipers ready.)

Corners and stop/start situations are always the worst. Too many cars going through before you and spinning their tires to do so have generally laid down a nice layer of ice. This is the real test of traction versus inertia. When possible, I've learned the Minnesota Winter Stop: Don't! This is not strictly legal, of course, so cover your a**es by stopping ahead of time while there's still some traction, then rolling slowly through. If you don't have to stop, you don't have to start. Inertia works for you, not against. Of course, this means other drivers have figured out the same thing, so you have to be doubly careful when approaching intersections for cars pulling out suddenly from side roads, or just poking their noses out that half car length it takes these days to see over the plowed up snow hills on corners to make sure that you are really there and heading their way. As in, RIGHT NOW!

Slick hills are an issue. In the "olden days" one fishtailed uphill, until front wheel drive swapped push with pull, a much more secure motion. Even with that, it was possible to not go anywhere while wheels just spun uselessly in first gear. It was handy to have a stick shift - or a reliable automatic - that you could pop into second - or one gear above whatever speed you were trying to obtain. That way the engine didn't have enough extra energy to spin wheels, just enough to get them going at the same speed that the car needed to move at.

Super cold days are really trying. When it's -15 F out there, those black bands going down your lane are not the spots that are cleared of snow, or where it has melted from salt, like they are on warmer snowy days. Those black stripes are where countless slow-moving cars have laid down ice from their exhaust pipes. Being ice, one should be able to predict the outcome when one driving on it has to turn or stop, especially at some speed. Unfortunately, hundreds of drivers every black-ice day learn the hard way. They are lulled by a sense of security because they can manage to get up to some speed. They forget can does not mean should, and going doesn't equal stopping ability.

I wish I could say that black means ice and white means salt, or black means clear and white means snow. Every day, every hour, every road, it can be different. One has to learn. And relearn. I have come up with only two hard and fast rules for winter driving. And no, one of them is not "Don't." I could wish, but....

Rule 1: Other drivers are stupid. You can't cure stupid. Not only that, it's contagious. You can catch it by getting too close. So avoid them. Stay back, stay alert.

Rule 2: Don't get arrogant. The world will quickly demonstrate to you that you can also be stupid. It comes with consequences. So, stay back. Stay alert. And be grateful you made it to your destination.

Take last night. I was in Eagan at 4:15, ready to head home. It's about 50 miles from there, even in heavy rush hour traffic only about an hour-and-a-half drive. Light traffic it's about an hour. I finally walked in the house about 8:30, and yes, damned grateful to be there. Here. I'm planning on staying here until Monday morning. There are books to read, TV to watch, laundry to send to the basement for a son to do so I can avoid the stairs, meals to prepare and serve/eat, naps to take.

Nowhere outside.

Not one inch.

Nope.

I can almost pretend it's not winter.

Echolalia

It mostly shows up on those mornings when he's managed to take out his oxygen in the middle of the night. We know his blood O2 levels drop like a rock when he's off it. Randy checks it both ways when she's here. We just don't know how much permanent damages it does him not to have it. The echolalia gives us a hint. Fortunately, it does not last. Return of the O2 stops it after a short bit. A typical conversation might go like this:

"Good morning, Daddy."

"Daddy daddy daddy."

How are You?"

"Are you? Are you? Are you?"

"Would you like a sip of water?"

"Water water water."

As he's coming out of it, he might start counting his repetitions. I tend to end my sentences to him when he's confused with the word, "Daddy," trying to help orient him to where and when he is and with whom. "Daddy, Daddy. That's two daddys. Daddy daddy." And then he'll look up at me with innocent pride and inform me, "I know my numbers."

The first time I encountered it, it rapidly became annoying. I asked him to stop it.

"Stop it. Stop it."

Sigh. Time for me to just shut up then.

Progress?

The wheelchair arrived on Friday. It was supposed to be a good thing, with walking from bed to living room becoming so difficult for my dad. I'm not so sure.

It's not just the practical details like having to lift it and turn it to go through the doorway, or its not fitting at all through the bathroom opening. Or the fact it's so new that it's stiff and hard to move - a perfect match for my dad if you think about it!

The real issue seems to be my dad's perfect willingness to become totally dependent. If you do one thing for him, he's suddenly unable, unwilling, or can't remember how to do it for himself. In some cases that's a safety issue. He doesn't cook any more, for example. So fewer chances to get burned or drop breakables when we do it. But the wheelchair gives him reason to take it a step too far.

So to speak.

Saturday morning I woke up Richard as usual to help get Daddy from sitting on the edge of the bed to his living room chair. I no longer feel competent to prevent a fall if he starts to tilt. I had everything ready I could, from transferring O2 tubing, to emptying his urine bag, to getting his pants over his feet and mostly up his legs. He has to stand up for the pants to come up the rest of the way.

He refused.

After all, he had a wheelchair now. Rich had to both lift him and swing him into the chair. Once of that was way more than too many times. I was called in to swing the chair around to directly behind Daddy so he could sit -plop! - back into it. There was no way to get his pants up all the way.

After Rich maneuvered him to a spot in front of his lift chair, we both tried to explain to him that he needed to help us by standing for a few seconds. We could help pull him up and help him balance, but he actually had to stand.

"Bullshit!"

After ten minutes of coaxing, explaining, and listening to a petulant 2-year-old, I sent Richard back to bed, and told Daddy one last time - I thought - that we couldn't do all of the work for him, and until he was willing to help, he was going to have to sit in his chair. Meanwhile I had things to do.

He was close enough to his nebulizer that I set that up for him to take, and set coffee on the table for him. Then I worked on my taxes for about an hour, hunting down paperwork and doing the necessary math on a year's worth of mileage figures. With a tranny replacement and a Bambi accident, there were several replacement vehicles to sort out and tally separately. And I need three figures for each: total mileage, personal mileage, and commuting mileage. The latter is further complicated by my having an early morning long-distance timecall for a couple months that stretched out the commute on those days.

I periodically asked him if he were willing to stand now if we helped him, so he could get into his comfy chair. His answer was always, "No," and between times he was complaining how uncomfortable his wheelchair was, how cold he was getting, how awful his coffee was today. We were so mean to him!

OK, sure, whatever.

I agreed that his chair must be uncomfortable, and his other chair would be much better. I agreed that it was cold, but unless he stood we couldn't pull up his superwarm fleecy sweatpants. I could add a throw, however. And sorry, but the coffee was the same coffee he'd been drinking here for ages, just now it had the thickening agent in it that the doctor said he needed so he wouldn't choke on it. We'd been having this particular discussion for several days now. But I have years of daycare experience behind me, and have dealt with dozens of occasionally stubborn kids. You can't force them to do what they refuse to do. You can, however, influence their choice by allowing or imposing consequences. If you won't stand, you stay where you are. As soon as you are ready, we're happy to assist. Cold? Here's a blanket. Uncomfortable? There's a better chair, when.... In the process you have to remain as matter-of-fact and cheerful as possible - if possible - and let the insults and abuse roll off your back.

It took two hours, when he finally decided he was willing to assist. I called Paul out of his room to help. He is bigger and stronger, and I wanted him if we had a problem. At first Daddy's version of helping was lifting up his knees and letting his feet cross under him - and off the floor. Paul finally coaxed him by giving elaborately detailed directions (Put that foot over here, put this hand here and push, etc. ) into standing. I pulled up his pants, removed the wheelchair, and Paul coaxed him into turning and sitting.

At last!

Now I could serve breakfast and continue about my day.

A little before noon his physical therapist popped in unannounced. Was this inconvenient? Oh heck no! Perfect timing, in fact. I explained what the morning had been like, and she made that her day's project. Partly it was convincing Daddy that safety issues were involved. He wouldn't hear it from us but listened to her. (Typical kid.) Then she showed Richard how to manage him, made Daddy practice standing and lifting up on to his toes (!), walking down to the bathroom and back, getting in and out of his chair. She took his vitals and was pleased to discover, as Randy had earlier, that his lungs were clear and his O2 levels were good.

There was no reason he couldn't do some exercising.

She spent some time looking over the wheelchair, and decided to order what is called a transfer chair for him instead. What he has is too big, and has "table arms", meaning they fit nicely under the table but do not extend far enough forward for him to get a grip that shifts his center of gravity enough forward to enable him to stand. He doesn't need the footrests which increase its dimensions, regardless of how they are turned, making doorways difficult. He also doesn't need the second outer wheel because he's never going to move himself using his arms.

Eventually her work for the day was completed. Daddy became more agreeable (he slept for a couple hours), the wheelchair has gotten parked in his room, and the walker brought back out. He's since made no complaint about walking from his chair to his bed, or the reverse.

The petulant child has not disappeared, however. Last night he woke at 1:30, insisted that the lights go on because it was really day - somewhere. It had something to do with round being round but it seems I was being obtuse - and when I offered him his usual pills to help him go back to sleep, he refused. After a few minutes of tending, I left and returned with the pills, popped him in his mouth, and offered him water. He drank the water, but took time to spit both of the pills out onto the carpet!

Whiteout

The remarkable thing was, if you lifted your gaze about 15 degrees up from the horizon, you'd see mostly blue sky with a few dotted clouds. But that needed to be a quick impression in passing, for gazing longingly at it was not a good plan for keeping the car on the road that one could barely see most of the time, and not at all the rest of the time.

It was not an advertised whiteout. I'd switched to the local MPR station, and not a word was said. There was plenty of commentary on Science Friday to soothe a mind trying to overload on adrenaline, but nothing on the weather. It was a non-event.

Save for those of us who were trying to drive through it.

After climbing the hill out of the river valley that St. Peter snuggles in, taking Hwy. 99 towards New Ulm, there's a whole lot of flat. This morning there had been a bit of light and fluffy, and this afternoon brought steady increasing winds to move it about. Perfect whiteout conditions at roadway eye level.

Slowing way down helped, but even at 30 mph there were times when the road disappeared completely and one could only hope that it kept going straight for the next 20 to 100 feet or so until a glimpse was available again, and that the oncoming traffic could see it better than you could. When they were there, you could generally see the tops of the cars, more of the tops of trucks, and guide yourself by steering to the side of them until the road reappeared. You were fine as long as there were no stalled cars, pedestrians, wandering cows, or deer. Luckily, there weren't.

Windbreaks earned their names, breaking up the wind enough that the road became visible. It didn't matter if it were a lone tree or a row, a clump or a section, as long as it was within a quarter mile upwind, it did its work. The really dangerous places were where it was just open fields for as far upwind as you could see. Approaching them from a place of visibility, you could see what you were in for. Once there, you were taking your chances. Often there was enough roll in the landscape that you could see that the road went straight, or curved left or right, and adjust accordingly. If following another vehicle, like a tall truck, you at least had a road guide, but for the first 12 miles, there was nobody in front of me. I was the slow leader. Even after I pulled over at the first good spot to let others pass, which was at Nicollet, the first town, and proceeded to follow the others for a change, they quickly outpaced the speed I was willing to go. I still slowed down for the zero-visibility stretches, and was starting to have to slow for building drifts.

By the time I passed Cortland, the road dropped down to parallel another river valley, and conditions eased. It would have been great if I didn't have to come back. But I did, and by the time I'd made my stop and was heading back, conditions had worsened slightly. There was no longer blue sky. Drifts were now building on the downwind side of the road, but still were easy enough to drive through.

There was just one spot on the road where, once there, I wondered if I could forget the whole thing. Maybe park for a week or so. I'd just bitten off more than I could chew. At the western end of Nicollet, Hwy. 99 and 14 join - or split, if you're heading east. I needed to make a left turn across oncoming traffic. It had been no problem on the way out. I could see a full quarter mile, the buildings of town creating enough windbreak. On the return, however, I was completely blinded. I could see cars coming out of the snow only about 20 feet from where I had to cross.

Oh shit!

A quick glance behind me revealed a large truck patiently waiting for me - and keeping me from backing up and changing my mind about maybe taking 14 instead. Across the intersection was a red pickup waiting to make a right turn, heading the same way I had on my way out. I didn't know if he could see better than I could. I could only hope. I watched him. He sat. Cars came. He sat. Nobody came. He sat. Nobody came. Finally, he moved, and I could only pray that he had some sort of clue that it was safe to do so. When he moved, I did too. And, I noted, so did the truck behind me, up above the swirling blinding snow, and I presumed with a view that indicated it was safe for him to do so.

Crossing that intersection was a pure act of faith.

This time it worked.