Grumpy Young Man

It didn't seem like such a big request when it was made, or when it was accepted.

My daughter and her husband just went on vacation to Canada to visit friends for a few days. I expect, with her usual thoroughness, she thought of everything that needed doing before they left: mail, the cat, how to pack for the flight, all the usual.

Because it's winter, and they live in Minneapolis, she had to add one more thing to her list. Minneapolis has an ordinance that requires property owners to shovel sidewalks within 24 hours of the end of a snowfall. She asked my youngest, Paul, and he accepted.

No big deal.

By now you've likely seen the film of the Metrodome ripping and dumping some of its accumulation of the 17" weekend snowfall on TV. There was to have been a Vikings game there yesterday, if the Giants could manage to fly in from Kansas City, where their plane got diverted to Saturday because the airport here got shut down. Due to the roof collapse, it'll be in Detroit, tonight. Eleventh Avenue runs along the south side of the Dome, the angle most of the outside shots are taken from. About a mile later, it runs past my daughter's house. One can safely assume that 17" is close to their snowfall as well.

Now Paul is the most easygoing of my kids. He cheerfully helps out when asked. But yesterday was not a good day for him. While we didn't have nearly as much snow here, as it turned out, what we did have blew off the roof and onto the driveway, which his brother had cleared the evening before. He just hadn't bothered with the drift around and over his brother's car. We couldn't actually see it from the front door, so it looked like all the new shoveling remaining on Sunday morning was a couple of foot high drifts in the middle of the drive.

Paul timed himself accordingly. His plan was to quickly dig out of here, dig out his sister's sidewalks (corner house, 2 sidewalks), and then hit a movie or two on the way home. An hour later he was just getting out of here. He was not a happy camper.

It was getting dark by the time he returned. He reported that the snow he shoveled came to just over his knee. That was just the sidewalks. One street had been plowed, and the plow drift left behind was about shoulder height on him. He opened one of the curbs, but left the other to wait until the plow passed there as well. He didn't even bother with their driveway.

He spent another half hour in the den on the computer when he got home, looking for a movie he could still go to that appealed to him, and had a showing that qualified for matinee pricing. I hoped his mood would improve after he returned from that and had some of the venison crock-pot supper he'd helped prepare the night before.

On Morphine

I've learned some things about morphine recently.

I already knew it wasn't addicting if you used the proper amount for pain. I already knew I wasn't worried about addiction for end-of-life care. But I thought it was only used for pain. Apparently not.

It's been prescribed for my dad. That's not because he's in pain, because he says that most of the time he's not. But it opens the sacs in the lungs, helping him breathe better. It works well with the Atavan which relaxes the chest wall muscles to make more room for air. That's why he'll be getting it.

We think the Thick-It used in his beverages is causing diarrhea. (Something is, and that's the only big dietary change, other than decreasing amounts of food intake.) Morphine will actually work against that, tending to cause constipation. If we're all really really lucky, it will balance out.

We won't find out until Monday. Well, Tuesday, really, since I won't be bringing it home until after work Monday. That's because it can't be called in to the pharmacy over the phone from the doctor's office, nevermind caller ID and any other prescriptions or identifications that make the caller legitimate. Paper is required. And I won't be picking that up until Monday.

Monday is when the doctor's office opens again. And it's when I also stop in for the doctor's signed DNR orders that we can post in the house, proof that CPR need not be tried if EMTs ever get called. And even more than that, Monday is when I venture out of the house again, after the storm blows over, when we know the possibly 18-20 inches of snow and whatever drifts the winds create playing with it have a chance to be cleared off the roads.

Meanwhile I'm contentedly snowbound.

Another Visit From Randy

"Released into hospice". That was the official word on his discharge.

I was seriously wondering if I'd bitten off more than we all could chew when I picked up my dad from the hospital this afternoon. He had trouble standing, much less walking the two or three steps from his chair where he was eating lunch to the wheelchair for his ride down to the front doors. Same thing for his transfer into the car.

How on earth were we going to get him into the house?

It took both Rich and me to help him get on his feet out of the car. Once attached to his walker, he made a bit of progress, but we had a chair waiting for him immediately after he crossed the threshold. He sat for about ten minutes, during which time we raised the seat of his lift chair, changed his oxygen supply from the portable tank to the house feed, emptied the car, removed his hat and jacket, and Rich maneuvered his chair with its tiny wheels across the carpeted floor to sit next to his lift chair. With help again from both of us, he got seated into his lift chair.

Problem was, he couldn't stay there. Sure, we can - and did - bring supper there, but there's the matter of bathroom breaks, and heading down the hall to his bedroom at night. If he stayed this disabled, how would we manage?

I called Randy, letting her know he was now home, and she could visit at her convenience, as previously arranged. She arrived within an hour.

He came home with new meds, one of which seemed to contradict what another one was. She explained, letting us know to keep using the old one on schedule, but we could insert the new one in between if necessary. Another had extra benefits as far as breathing: it was a sleeping pill but also relaxed the chest wall muscles so it could expand while he was sleeping. She also said it could be given again if he woke, as he often does, at midnight and had trouble getting back to sleep. She would pursue getting him a second Rx to allow for extra usage.

She made sure Daddy knew what hospice is. He's had it explained to him several times in the hospital, but didn't recognize the word this afternoon. He knows perfectly well where he is in terms of his life expectancy, and easily explained that to Randy, adding that he had accepted it and was finally ready to go any time. Words, specific words, however, cause him problems. He's lost their meanings or can't recall the one he wants at the moment. That's progressive. He refers to it as holes in his brain.

We work around it.

She made a late afternoon phone call to the person she knows who can order him a hospital bed delivered to the house - and charged to Medicare. It's extra-long. He complains that my full-sized bed is shorter than normal. He's just taller than normal, and has been used to a queen bed with Mom for many years. This new bed will let him stretch out and keep his feet covered. The bed will arrive Tuesday or Wednesday. Meanwhile we may continue to have nights like last night where he wakes and wanders into the living room to sleep in his chair so his head is elevated. This means his strength is returning, something we noticed several hours after he came home. It also means nobody is awake to switch his oxygen over to the tubing in the living room.

Luckily I made a mid night potty call and saw him in the chair, switched the tubing, and covered him with a throw. He's been sleeping well since. I wish I could have.

But he walked it! Hooray!

Now I just have to figure out sheets for an extra-long hospital bed. And get memory foam for a topper. Not egg-crate. And, if we rent it for six months, it's ours. Like the nebulizer. Oh, and the height-from-the-floor adjustment is a hand crank. Medicare finally began to offer hospital beds for home use with electric head and knee lifts. Those used to be hand crank as well.

We discussed the "Thick-It" we need to add to his liquids. This gets them to a variety of consistencies, as we've already found out. There is a learning curve! The hospital says "honey", though many of his liquids didn't arrive that way. We've gotten slightly thick to solidly jelled, so far. Randy said "nectar" to "honey" works well enough. She doesn't care if his plain water is treated or not.

Then she asked if he remembered what he was taught about how to swallow?

Huh? News to me, and apparently to him as well. There's a "how"? And obviously nobody was taught. So she demonstrated. By swallowing with the chin down, the airway is closed off even if the mechanism is no longer working properly, like his. You can't aspirate. It's exactly the opposite of during CPR when the head is tilted back to open the airway. So Daddy tried it, and we now know to remind him to do it.

Randy decided to order up physical therapy for him, as she'd planned after his first hospital stay. The focus will change, however, to strengthening muscles that will assist his breathing. That brought up the issue of the focus of hospice vs. the focus of the county health agency. She will focus on keeping him as well as possible for as long as possible, while also keeping him as comfortable as possible. Hospice focuses more on comfort care. Each gets paid differently by Medicare, but simply because he is post-hospitalization, two hours of home health aid support daily will be covered for 6 months, as well as the PT. She can work on the bed, catheterization changes (he was sent home without the Foley and leg bag when he was too weak to get to the bathroom without help), fighting for meds needs, etc. The added bonus to staying with the county is their staff knows him and his needs already. They know how to deal with his blindness and his memory. And he trusts them.

What the county does not offer is 24-hour care, which he does not need yet. Hospice, I'm told, can. They are coming out this morning to make their presentation, answer questions. Randy tells me that they do not cover home health aids for two hours a day, so far the most expensive part of his home health care. I'm thinking we stay with the county for now, although I'll wait to hear what hospice says. Should things change, we can switch over, or take what's best of both programs, paying some expenses ourselves.

We'll see. Meanwhile I need coffee.

Just Which Part of Blind Don't You Get?

There's a dry-erase board on the wall in my dad's hospital room. It lists his name, nurse/aid of the moment, family phone number, dietary needs, and other important information needed at a glance about the patient. One of those items is "PT is legally blind".

The first evening I was there to see him, the TV in his room was tuned to what I later found out was channel 71. There is no picture. There is music, nice soothing selections like the "Moonlight Sonata" by Beethovan, or "Nutcracker" selections. The music is sprinkled with bird calls, some of which we actually recognize, like chickadee and cardinal. He enjoys listening to it.

Nearly all subsequent visits, the staff has turned the TV so the picture is on and the sound off. Last night I corrected it immediately - as I do now that I know how to tune in the good stuff - and the next staffer to walk in "corrected" it to screen on, sound off. I changed it again, and before I left somebody had again "fixed" it.

If Daddy could see the controls, I'd teach him how to do it himself. But if he could, he wouldn't need to. And that leaves him at the mercy of the staff. So tell me, guys, just what part of "blind" don't you get?

Come Back Soon

It was off the beaten track. It didn't used to be, but a freeway bypass has kept me going past the town rather than through it, unless like the other day it is my specific destination. Heading east out of Long Lake now, there is a sign along the road at the junction of a side road that invites us to "Come Back Soon".

Since the speed limit there had increased to 45 mph, I had only a brief moment to look up the road to try to determine who wanted my business. Up a small rise, before the curve, I caught a lovely view of a smattering of headstones in the local cemetery.

Bracelets

The first one is white, with a wide space for a typed paper insert, giving his name, address, birthdate, and other information the hospital deems important.

The second is orange, marked in large letters "No Known Allergies".

The third is yellow, warning that falls can be an issue.

The fourth one is purple. It simply says DNR. This one was a long time in coming. Even yesterday he was telling the doctor that he wanted all possible measures taken to revive him should his heart fail. The doctor gave me two reasons that was not a good idea for him. First, should his heart fail, he could be deprived of oxygen long enough to cause serious brain damage. Second, any chest compressions would most likely break his ribs at his age. Thus any remaining time gained by CPR would be spent in pain.

We want to keep him as comfortable as possible. That's why he's likely coming home tomorrow. We'll know for sure after the lung specialist examines him again tomorrow. He'll be more comfortable at home. It won't make any difference to his pneumonia, which they have determined to be chronic rather than acute. That's why no fever, no real progress. Still, he'll likely get sent home with antibiotics just in case they can do some good. Being home won't help the fibrosis, or the emphysema, or the infiltrates found on his recent CT scan. And being home won't help his congestive heart failure any more than staying in the hospital would.

Nothing can.

But he can feel better here, more cared for, more comfortable.

He understands he will not be getting better than he is right now. He discussed his funeral, wanting to make sure he'd be cremated, his ashes buried alongside Mom's at Fort Snelling. I said, "Of course." Mom's urn has been waiting in my living room for 20 months now. He doesn't want us to be devastated when he goes, and joked that I didn't need to agree quite so quickly. His sense of humor is still there, along with his gratitude and appreciation.

He wants more help, so he can do less work, need to struggle to breathe less often. I'll be looking into what kinds of things can be done here at home, what kinds of assistance is available and who'll be paying for it. Tomorrow I'll have to ask at the hospital if they believe he qualifies for home hospice care. That would open some doors.

I think we'll leave the purple bracelet on.

A Day In The OMG

I hope it's just a phase. I'd like to think I'll get my sense of humor back, that I can get through a day without feeling on the edge, without mentally swearing at half the people I interact with, without feeling ready to lash out for real. Maybe just a simpler day or seven. Maybe some more sleep. Something ought to help.

"Urrrhh"

I hear it on the baby monitor, not sure whether it's a call for help or just more talking in his sleep. One eye opens. 4AM. Maybe it's a false alarm.

"Urrrhh!"

No such luck. I get out of bed, head through the house, and open his door. I bypass the bathroom without stopping, grateful that I woke and used it an hour earlier. As I open his door I hear him calling once again, "Nurse!"

"It's me, Daddy. What do you need?" Realizing now where he is, he asks for a drink of water, and for me to check his nose tubing bringing oxygen. He's never convinced the one in his bedroom brings as much as the one in the living room. Maybe it's plugged? I'll go through the motions of checking, although I can hear the hissing halfway across the bedroom. It's not plugged. For that matter, part of it is not even there to be plugged. He's got a prong and a stump, not two prongs. Did somebody get hungry in the middle of the night? It seemed fine when he went to bed. I reassure him everything's OK for now, that we'll fix his nosepiece tomorrow, but if he can hold on for an hour, we'll get him up then and get him out to the living room where he can breathe better.

Maybe I can get back to sleep soon enough to do some good.

5AM and the alarm goes off to MPR news. I don't want to listen to whatever it is, and there's just not time even if I did. Put the dog out, hit the bathroom, take my pills...oh wait, Paul's using it, those have to wait... start coffee, clean up around his chair, rinse and reset his nebulizer, dig out his coffee cup and breakfast dishes ready for later, let the dog back in and give him his milkbone, set out the rest of my pills - the vitamins, etc. - and now it's time to wake up Daddy.

Please please hurry up Paul.

As soon as Daddy is in his chair, which now takes twice as long as normal, I dish up coffee for both of us and we watch just enough local news to get headlines, traffic and weather. Paul finally finishes his shower, and I can get in, do what I need to, and fix Daddy's breakfast. I bring it to his chair, get his portable O2 tank set up to go along, find his jacket and knit hat - Paul's, actually- and remind Paul that they need to leave in 15 minutes. Daddy has an early morning post-hospital doctor visit. Paul is driving him. They leave late. Paul comes back in to get a plastic wastebasket. Daddy is nauseous from the exertion of getting to the car. They leave even later.

I finally grab my shower. Coming out, I hear a very familiar sound: more bad news. It's Thursday morning, garbage pick-up day. Nobody put the can curbside. And since last week was Thanksgiving, and pick-up day moved to Friday when we were focused on bringing Daddy home from the hospital, nobody had put the can curbside then either. And right now it's winter out there, I'm in lightweight PJs, my hair soaking wet, my feet bare. I'm not even tempted to try to run out and race the garbage truck.

Damn good thing it's a big can!

I get dressed, and head out, not yet to work, but taking advantage of my early start to go for the $10 off early bird oil change special. It's a bit late, mileage-wise, even by my relaxed standards. There's just been no time. I mention that my tire low pressure light has just come on, (causing another delay while I inspect each tire for its likeliness to last the trip to here), and ask them to check. I'm later informed that each was 5 lbs. low, no doubt caused by the weather. Yesterday's similar weather didn't have an effect, but this day must be special.

I'm just getting into the Dan Brown book I've been working on for a week - again, no time - when the squirt calls me back into the service bay for a chat. He wants to verify my address is the same - he couldn't just ask in the lobby? - and show me his little power point presentation of all my options of oils and extra services along with charts of what the manufacturer recommends. My knees are not amused. He's got all my information from numerous previous visits. I forbear mentioning that I've put 2 million miles on my own cars, am very well aware of dealer recommendations and actual tolerances, both of the cars and of my budget. I cut him off, tell him to just do the usual, and that I'm not planning on standing there.

Hey, squirt, notice that blue card under my windshield with the little wheelchair symbol on it? It should show up even better when you clean the windshield like you are supposed to have done.

When it's time to pay he makes a snotty comment about my air filter being dirty, but they just put it back in. Now that they could have asked about, provided, of course, that they brought it out to the lobby. Pissant!

Once in my car, I log in to work and head down the road. I'll stop for breakfast in my usual stopping/waiting place, likely the McDonalds. Just as I pass the last place to turn around for over five miles, three runs come in - behind me. So far behind me that their origin is considered out of town. So 5 miles later, I u-turn and head back north. When I'm back in Forest lake, I exit at their McDonalds and order, to eat as I continue north.

When it hit my first destination town, I stop and ask where the post office is. By now it's 9AM, and I have to mail a package. Priority. When Steve left yesterday afternoon, he left behind his cell phone. Since it's over a hundred miles, Uncle Sam can do the walking. At least the phone was charged. When he was here last week, he brought the phone and left the charger home. This week he'd brought - and remembered to pack - the charger. I called his son last night, telling them I had the phone and would mail it. But what was his address? I can drive right to it, but...

It's a picturesque post office. There's a single window open, and the lady ahead of me in line needed a lot of stamps. Of the specific variety that wasn't in stock at this particular window. The fellow didn't trust his counting and had to do it three times, then figure the price twice, and chat, then refold the stamps for their folder, and.... My knees were again not best pleased. Once it was finally my turn, he directed me to the far side of an unlikely looking display for my priority box. Way across the lobby, of course. "Next?" So I get to fill it out, and return to the line at the window for mailing.

The pick is a pharmacy. I know this customer. Their clients are hospice patients. Never a happy time, but usually it means somebody is there who is lucid, most times a family member, and who knows how to give directions to the house. Out there there are no maps better than the state map, and these three runs go to three different towns even further out than where I'm picking up from, so I need all the help I can get. I check each package for phone numbers. Nada. Zip.

The usual out-of-town plan is to go to the first gas station you can find and ask directions or, better yet, for a local map to look at. The first town doesn't have a gas station. OK, call dispatch and ask them to call our customer and see if we can get phone numbers for each drop. I do that, and get switched over to the driver helper. I explain my predicament. It's compounded by the fact that the address numbers I'm looking for don't work in this town. It's a 5-digit number starting with 49, where the ones in town start with 36. It should be way-y-y-y north of here. She suggests I call the customer, and I tell her there's no numbers on the freight. She very patiently and politely informs me the numbers are on my Nextel, if I scroll down way into the nether regions that I tend to forget are even there, since they are 1) invisible and 2) seldom used. I check, and sure enough... oops. Thanks. Bye.

I get pretty good directions, once I get the woman past the idea that I might have any clue at all where the red barn is that used to be a .... They're just not in this town, as claimed by the pharmacy sending out the meds. In fact, I passed the turnoff at the town before this one, so I need to go back, then head east about six miles past the ____ Store and over the railroad tracks and about three or four more blocks and.... As I finally arrive, I realize the numbers were so far off because I just crossed a county line - into my own county, in fact - and we use a whole different system. Now it's perfect. Well, aside for the fact that the road signs are still completely covered from the sticky snow of two days ago and I have to pass each one, stop, look over my shoulder, and see if this is the right road or not. Nobody ever cleans the snow off the signs.

Whee.

After dropping this one off, I stop and write myself clear directions in case I get to come this way again.

OK, call number two, town number two. These directions are all about bridges and "cattle ranches" and the farm machinery in the front yard. They won't be home when I get there but leave the package in their mail box. I refrain from commenting on the legality of that particular move. Their two dogs are friendly and will be out in the yard. I do comment this time, suggesting that they will likely be too busy smelling the two dogs from my last stop to bother me much. I'd had to keep them entertained so the woman there had a free hand to sign with. I find this drop mostly despite her directions, give the two largest dogs I've seen in years some time to get accustomed to me, try the door in spite of her saying they'd be gone because that's what we have to do, and then put the package in the mailbox. At least there's a name plaque at the door, even with no number out on the road. I know I've found the right spot. Again, write directions so they make sense, in case.

Call number three, and I know I'm in trouble. The guy mumbles, and from the directions he gives and the long pauses throughout his sentences, I figure it's a good thing he's home already because otherwise he'd never find it. He does keep repeating if I get to (illegible)I've gone too far.

Oh goodie.

Time to head into town for the old tried-and true. Besides, I need a pit stop. Luckily, this time there's both a map and someone who knows what I'm looking for. I passed it about three miles east of town on my way in - why couldn't he have said that? - but it's really simple once you know the street is the same as the county road. Then it's just a matter of looking for the address number on the fire number sign. I never did get to find out what I'd see when I went too far, because I didn't get there. But I did find him, driving out his driveway as I pulled up, then backing up to a turnaround, and heading up towards his house again parallel with me until his wheels started spinning on the ice-coated snowy grass. I figured if I stopped, he'd stop, and I better stop him from spinning any more as he was slipping sideways downhill. Whatever kind of drugs he was getting, apparently they didn't cure stupid any more than they cure whatever was killing him. They did seem, however, to be keeping him happy.

I guess that's the point.

I had to leave the driveway in a bit of a hurry since his caretaker pulled in just as I was leaving. There's only so much room. I figure he needs her way more now than he needs me. I wonder what other kinds of trouble he can get into on his lonesome. I did stop up the road and give myself clear directions to this place too.

Time to head back into the cities. By now I was starting to worry about Daddy. I should have heard from Paul about the doctor visit. He wasn't answering his cell. I'd already tried twice. He hadn't even turned on his cell. And they weren't home yet either. Just then he called, letting me know that Daddy was now in St. John's Hospital. He still had pneumonia in his right lung, was still anemic, and the doctor sent him over there.

Crap! Double crap: I hate that hospital. Don't get me wrong. They give excellent service. But they put such strong emphasis on the esthetics of the lobby it's a huge walk from car to patient room.

Time to call Randy and call off the aids until further notice. Got her voicemail, so I called Patty, one of Daddy's aids who is also a friend, who could call ChiChi in time for her to not waste a trip. Patty chatted a bit, bringing up in the course of it something that had been troubling her. Daddy had asked her earlier in the week what it was like to die.

Now we've gotten kind of used to comments like that. This very morning he'd commented that he'd thought dying was going to be easier than this, as he was struggling to catch his breath while I was getting him up and dressed. Patty hadn't heard many of those comments and takes them very much to heart. So she answered him, bless her heart, with, "Well, I haven't tried it myself, but I hear it's usually peaceful." I tried to thank her for her thoughtfulness, put this morning's comment in a new context, and tried to reassure her that this was fairly typical for him when he's sick or depressed.

Next call was Meals on Wheels, not in time to cancel since by now it was 11:30, but stop for tomorrow and until I called again. Then my brother Steve, letting them know what's going on.

All this time, I'm wandering around on unfamiliar roads, working my way back to Hwy. 65. I knew it was east of me, and the cities were south, and if I kept going east until I had to turn, south until I could go east again.... I'd come down about 7 miles on the county road from the highway to the last fellow's place, and didn't feel like heading back all that way north again. Eventually it worked, but it was slow. The country roads, of course, were all iced from two days ago. But the phone calls were a long way from done. But hey, lots of time while I drive back to the cities.

I called "my" Steve's son, informing him that the phone was mailed and what was going on with Daddy. Then there was Planning Commission. Doubtful I'd make it by 7PM, but lucky I had one phone number of a member to call, make my excuses, and let them know not to wait for me. Then I called Lynn, the city clerk, and left voicemail on the same thing with her.

Next was Daddy's bank, checking whether Blue Cross's direct deduct bill had cleared in the confusion between closing the old account and opening the new one. I'd thought I could take care of handling them, Social Security, and his pension check from an unknown company, getting them switched over. Boy was I naive! Social Security will only take that kind of orders from the bank itself. Blue Cross needs to send paperwork for Daddy to sign, which they're slow on. And the mysterious company is still mysterious. Sara has been a great help, so I called her to check how things were going, this being the first of the month.

Sara is on vacation. They gave me Kelly. She'd have to call me back, since the person she needs to check with is at lunch. And she can't tell Social Security to switch the account numbers since their bank doesn't offer that service. (Sara does. I guess someone forgot to send her the memo. Shhhhhh!) There will be more calls required tomorrow.

"My" Steve called back. I filled him in on both situations. I informed him I only needed the smallest Priority box: last night when I got home I checked around the house for his head, but since I didn't find it, I guessed he'd had it screwed on when he left. (He wasn't all that amused.) I've been missing being able to pick up the phone and reach out. It's been nice to call as needed to check in, vent, listen, exchange support. Today it was especially welcomed.

Lynn called, letting me know that Planning was canceled due to lack of a quorum. Not to mention lack of business. Don't hurry home for the meeting.

Kelly called, letting me know that accounting is aware of the issues and watching for things as they come through. She couldn't tell me about Blue Cross, the one right now that I'm worried about. If that request for withdrawal bounces, his insurance gets messed up. Not a good time for that.

A bit of road spray clouds the windshield, so I hit the washer/wipers. Two teeny spouts of blue juice, and ...out! Really? Out? Hours after a full-service oil change? They worked perfectly an hour earlier. There will be another early morning visit tomorrow. I'll rub the squirt's nose in their top-off policy! While getting confrontational sounds like it might be appealing, in reality it's just another thing to put on the list, and the stack of things on that list is mounting. This whole time I'm worrying about Daddy, and everything on that list is changed in reaction to what I don't and do know or suspect about his health. Just changing the things on the list is part of the stack-up. No one thing is much. All of it is more than a lot.

For example: should I rush to select the picture for this year's X-mas card? I signed last year's card with a printed set of both of our names. Will he still be around then? Which would be worse: send it out with just my name? Or with both with the possibility that he won't be around then? Wouldn't either way, wrong, be cruel? We can hope he'll get better in the hospital, but he did last time and relapsed within a couple days at home. Will his body respond faster this time? Slower? Will we just yo-yo until he's gone, no real good days left, struggling to breathe for weeks and/or months? All of that background surrounds everything on the list, even if it doesn't directly affect it.

I call Rich at home to have him turn off the coffee pot, pop the coffee in the fridge. I'll have it tomorrow, another cup Saturday. It was barely touched. Oh, and turn off his equipment, lower the thermostat to our temperature, not the higher one we maintain for Daddy. Mental note: remember to unplug the baby monitor again, save energy that way as well. Coil up the oxygen hose, noting we can delay having Paul replace the chewed piece until it's needed again, if....

By now I pull into a gas station lot down in Blaine and have lunch, just a bit late. At least when the can of chunky clam chowder is cold, you can heap it on the spoon and not worry about wearing it on your uniform the rest of the day. The white would glare against the navy of the sweatshirt. Dispatch suddenly remembers me, and offers a pair of runs coming out of Coon Rapids heading to Zimmerman and Princeton: do I want them? Sure! Sight unseen. Of course. Three minutes later as I'm heading that way, only one shows up on my Nextel, just another frustration with the system. I switch modes to contact dispatch, technically an illegal act as it involves a wee bit of key pressing that could be interpreted as texting, to let them know my phone is having problems. He informs me that other run was canceled. "Hey, thanks for letting me know." Amazingly, there was no hint of sarcasm in the spoken tone of that comment. Written, it screams through. But he's a bit.... well, let's not go there just now.

The Princeton run is two boxes of printed material, going to the second floor of a building right on the main drag, easy to find. I've been there before. I also, come to think of it, now remember that there is no elevator in the building. I get to haul 68 pounds up stairs!

Lucky me. The anticipation grows.

Heading north, I mostly finish lunch, a spoonful per stoplight. As I drive I notice something disturbing: can that really be gas at $3.049? I paid $2.799 last night, and actually saw $2.659 once yesterday when my tank was still full. Yep, other sightings confirm the bad news. I'm hoping it doesn't spread to my area before I get home, putting (another) mental note on my list to fill up tonight, not in the morning. We usually trail the pack in my area when gas prices rise.

The UPS driver is pulling out as I pull in. I hope his boxes were lighter. Or maybe he delivered to the first floor. Anyway, I now have parking. No more excuses to delay on this one. I load the boxes on my two-wheeler, haul them over to the door, let one sit in the lobby as I hoist the other on my hip. Luckily it's just the right size for my arm to grasp one corner over the top with its diagonal corner on my hip. I start up the stairs, using the opposite arm on the railing to both balance and pull, doing what I call the two-year-old's stair climb. One foot goes up, then the other joins it, same step. Repeat for each step. It's made more interesting for the scrinchy-grinding sound I hear as each knee joint moves under the extra weight. It's pure bone conduction, straight to the brain. I suspect the accompanying nausea is purely psychological. The same sound greets me as I step out of the tub in the morning. I know what these are going to feel like tonight, and likely several days more.

Entering the office, I announce that this is just the first of two boxes for them from ____. Here I catch a break. One of them offers to come back down with me and haul the other one up.

Bless you!

She signs, I leave, heading back to the cities after finally scooping the last of the clam chowder from the can. It was particularly unsastisfying. Right now I'm needing some comfort food, and stop for a bag of popcorn to munch along the way. My carpet has just been cleaned along with the oil change, so there's plenty of room for new crumbs, white on black. Dispatch aims me towards Anoka. Plenty of time to drive and brood about Daddy, how he's doing.

I let dispatch know I need to look towards Maplewood tonight, so of course they give me a run heading to Eden Prairie, diagonally as far away from there as possible while still remaining within the 494/694 metro perimeter freeway ring. I know which particular dispatcher this is, and have come to expect his pushing our limits as much as possible. He rarely disappoints. Still, I drop the run at 4 PM, issuing another reminder of where I'm aiming. He sends me down to the Flying Cloud airport for a run to Eagan, which at least covers the eastern part of my northeastern trip. After I accept, he mentions it's not ready until 5 PM, but hey, I can walk in early.

Well, typical of him, even more so as the run progresses. This run is freight forwarder to freight forwarder, an envelope of customs documents. They wonder why I'm there a few minutes early. This never goes off on time. We should know that. (Yeah, I agree: dispatch should know that!) They have to wait for customs to clear the freight, and customs has their own priorities. My need to get to the hospital at a reasonable time to see my dad is distinctly not one of them. But would I like a cup of coffee while I wait? And there's a nice seating area just behind the fireplace.

She was right about the nice seating area, and next to the fireplace is the warmest part of the lobby. I quit shivering as I soak in the heat, but the fuming mounts as time passes. I pass some of it by texting to dispatch about what's going on - or rather, not going on - and comment that this is typical for this place and that they, dispatch, should know this. After about 4 comments, I get a query, was there a delay?

Well, Duh! Hey, idiot, have you been reading any of this?

After several more minutes, I approach the front desk again. I've had enough, If it can't be ready in about two more minutes, I'm prepared to walk out and a different driver can be sent in. They'd have to call us first, of course, but.... Sometimes customers need to be reminded we're not their personal slaves and have other customers to be served and other needs to attend to. It's done as politely as possible, but it will inconvenience them. Learn to use us wisely, guys. She calls back to the guy getting it ready, and lo, it's actually ready! He just has to walk it up to the front desk. I'm not told how long it's been sitting on his desk waiting to be brought up.

OK, I give them the two minutes that takes, thank them, and leave. Once in the car, I ask dispatch for loadtime charges on the run. The reply back is a verbal query: wasn't the freight ready when I got there?

Arrrgggghhhhh!!!!! We've just been texting about that very thing. You've confirmed my worst thoughts about your competence. Again.

I bite back all the nasty things I truly want to blast this guy with, but can't quite keep the sarcasm out of my tone. Well, tough. With his skills, surely he must have developed a thick skin by this time! You know, to match his thick skull. A complete, matching set.

I'm going to be lucky to reach the hospital by 7, late as it is, far as it is, rush hour in full bloom. I wonder if Daddy'll still be awake then. He's been going to bed lately any time between 4 and 7, since coming home from the hospital the first time. I mentally map the likely fastest, though not shortest, route to my drop. At any moment I expect the dispatcher to call me up and wonder why I'm not going his preferred route. He's done it before. It's in my contract that I get to choose. That doesn't stop him.

Once there, I walk in and stand at the counter. I'm the only customer there. The dozen others who pass by me in all directions are apparently not the person who has to wait on me. Or perhaps they have unseen broken fingers and can no longer hold pens to sign their names with.
Apparently all are employees, having free movement within the area and chatting with each other as they move around. Wait, here comes a likely-looking guy.

"I'll be right with you, sir." Sir? Again? I wonder this at his back as he passes into the next room. My knees are seriously unamused. I have plenty of time to study a poster next to the counter. Many companies have them. They are reminders of high company standards for service to their customers. Things to do, things not to do, pep talks on paper. This one lists nonproductive behaviors in a middle section, including saying, "Not my job." I have plenty of time to wonder if the dozen or so milling around me have read this and appreciate the irony. My actual thoughts are a tad less charitable.

No, actually they are a whole hell of a lot less charitable. I'm gritting my teeth to hold myself in check by this time, not swearing, managing a smile and a thank you when I do finally get that signature and can leave. Mentally swearing at them all and calling them out does relieve a bit of the stress, but only one thing really holds me in check: When I get home tonight, I'm going to blog! No ands, ifs or buts, don't care who else might be using my computer. I walk in that door, it's all mine! Mine mine mine! I've already picked out the title and the first sentence, and I'll blog till I drop. (Actually about 11 PM and about a third of the way through this.)

Finally arriving at the hospital, I manage to snag a front-row handicap parking spot. This place has three rows of them. None are actually close to the front door. The relative closeness of this spot I credit to the lateness of the hour.

Every time I have to come here, I spend time mentally cursing the architect who designed this space. Oh, it's beautiful! No question about that. It's just so inefficient, heat-wasteful, and way too damned long a hike from parking to patient rooms.

Take the circle drive in front, reserved for loading home-bound patients. It can't be a straight drive, allowing parking on the other side. It's got its own center island, a full island, with clumps of birch trees, decorative boulders, plantings and what-not. A semi could successfully navigate that turning radius.

Then you have the air lock, about 30 feet long, where one can sit in one's wheelchair with the flowers and detritus one takes along when they leave, nominally inside and out of the elements though the doors open electronically every time someone approaches and lets all that cold/hot air in, while you wait for however long it takes your driver to go locate the car and bring it around for you. Have patience. But, hey, you're sitting, right? Lucky you.

Next is the hike to the info desk. You pass a lovely water feature on your way, which some folks have turned into a wishing well, providing endless fascination for waiting children who kill time trying to figure out how to scarf up a few of those coins for themselves without getting into trouble. You have plenty of time yourself to watch them as you trudge by.

If you know the room number and your way, you can save the time spent at the info desk asking, and breeze right on by. Past the gift shop, with fabulous window displays of wares for sale. Past the coffee nook, past the fireplace with tables and chairs, around the corner, around another corner, through the first segment of art gallery (all for sale, prices marked), past the creche scene in the courtyard, past the vending machines and the nook with tables and chairs, past offices, past more art gallery, past another sizable seating area, this time no tables, around the corner, down the hall, and finally to the elevator nook. Push the button and wait. Head up to four, read signs for which wing your room number is in. Ahh, there, turn right, pass the nurses station, turn left, and - of course - last door at the end of that last hall.

I am, at this point, after all that turning, directly behind my car, about 50 feet back and four floors up. There's just no direct route here. Out of some perverse need, I counted my steps from parking to room on a previous visit. There were several hundred. This is why I curse the architect. May he be blessed with my knees, and with my need to visit this hospital three times a day for the rest of his miserable life!

Daddy's sleeping when I walk in, but there is one chair. You can tell it's a chair because it's what's holding up five extra blankets, two extra pillows, and a couple things whose function you're not sure of. It's certainly not ready to hold you. At this point, it doesn't matter. If there's something breakable under all that, too bad. Sit! The chair tries to repel me, the stack toppling forward under me. After rearranging, I hit the nurse call.

The aid answers, since his nurse is at supper. Lucky her. I'd like some of that myself. By now Daddy is awake, and the three of us have a good long chat. He's feeling better, getting antibiotics via IV again, and comfortable with a Foley and bag so he doesn't have to get up. They even bring bed pans to him here. The room is hovering somewhere close to 80 degrees, quite comfortable for him. Even his perpetually cold foot is refusing to bother him. I make sure they know everything relevant about his special needs, and the aid lets me know what they're doing for him to meet those. When I point out the burn on his foot, most likely from the super-hot hot packs to keep his foot warm in the other hospital, she seems shocked. They haven't been allowed to use hot packs here for a long time: too many patient burns.

Ya think?

For his vision problems, they taped a gauze "bump" over the right button to push on his call button controller, one that puts the many choices on my TV remote control to shame. Not only can he now find it, he's been using it through the day. The TV monitor is off in his room, but there's a selection of music and animal and bird calls piped into his room. It's very soothing, at a level that just barely penetrates his hearing, enough that he likes it.

It's the same thing they had in Mom's room here when she was dying, but she (or rather we, her visitors) had the video as well.

After satisfying myself that he's getting good care, and comforted that he knows that I've visited, I let him persuade me that it's time to head home. I do have to work tomorrow, which the forecasters promise will be snowy, and I will need some sleep. Before that, I'll need to unwind, but I've got my plan for that. Supper will be fast food on my way home. French Dip at Arbys is demanding my attention, and I comply. Rather than sitting parked and dipping, however, I decide to try another plan so I can drive and eat. Opening the sandwich, I pour the au jous over the baguette, reassemble, folding protective wrap over the bottom along with a pair of napkins to soak up most of the drips. It pretty much works but those last bites are unpleasantly soggy. Still, I am making progress home.

I actually manage, once in bed, to sleep through to the alarm.

Dang, another day! Already!

But, hey, it's just stress, right?