Day 50 – Good, Bad, Ugly & Kafkaesque

Terry, John, CeCe, Eli & Ellie visiting mom at Park Regency Care Center

A lot has happened in the past 2 weeks!

appointment slip for mom's neurologist visit

2/29 – Neurologist

As you might know, mom has had drop foot on her right (injured) foot. An x-ray previously revealed no damage to the foot. Today she saw a neurologist, Dr. Chan Kim, who performed a nerve conduction test. He reported that the drop foot is due to nerve damage. Mom asked if it would heal over time and he replied,

Only God knows.

They made a brace for her that fits in her shoe and appears to make the foot behave functionally normal.

3/2 – Wheelchair

Monday’s neurologist visit was pretty disappointing for mom. But there was also good news. Up until now mom has been spending 20 or 22 hours a day in bed. This week she transitioned to spending the entire day out of bed and in her wheelchair. What fantastic progress. What an incredible relief.

Terry, John, CeCe, Eli & Ellie visiting mom at Park Regency Care Center

Terry, John, CeCe, Eli & Ellie visiting mom at Park Regency Care Center

3/7 – Candace

Today Dr. Susan Keisner’s Physician’s Assistant Candace told mom she’d be discharging her on Friday. Curiously she told mom she was discharging her, but when I called mom’s Park Regency Case Manager Kat, we found that Candace had not actually write a discharge order.

As Kat, Dr. Keisner, and everyone has told us, if you don’t make enough progress, CareMore throws you out and you don’t get any more Physical Therapy or Occupational Therapy. I was surprised that Candace was discharging mom since the last thing Dr. Keisner had said to me was,

Your mom is making all kinds of progress.

And that she was good to stay for at least a couple more days. So Candace discharging her was a surprise. When I spoke to Candace she explained that she was not discharging mom for failure to make progress, but that actually she was making too much progress and so she was discharging her for that!? When I asked about the Catch22 of being tossed out for insufficient progress and also tossed out for excessive progress, Candace’s only response was to laugh.

Mom actually is doing pretty well with physical therapy (lower body) but her occupational therapy (upper body) is only starting this Friday 3/11. If Candace discharges mom on the 1st day of occupational therapy then all the pain and suffering of the shoulder replacement surgery will have been only to go home with 0 range of motion!?

People like Park Regency’s Kat have encouraged me not to be upset with CareMore. That they are only doing what any other American HMO would do. Still, when the corporation you entrust your health and your life to acts so cavalierly and uncaring, it is beyond depressing. When the corporation that pledged to care for your health kicks you at your lowest, most difficult moment, it is beyond words. Instead of helping, they take your worst life experience and work hard every day to make sure it is even worse.

Tiki resting on mom's legs

3/7 – Tiki

Tiki bit a nurse at Park Regency tonight. Tiki was laying on the bed with mom when the nurse came in to give mom a pill. The Nurse handed mom a little plastic cup with the pill in it – Tiki growled. Then the nurse handed mom another plastic cup with water – Tiki snapped at her. Tiki did not seem to break the skin or draw any blood, it seemed to only be a scratch, still the nurse was understandably very upset. She disinfected her finger, asked us about Tiki’s shots, and told us she’d be in touch on the matter.

Tiki’s always been unfriendly to strangers. Maybe it’s her nature. Maybe mom and dad just never really put her in social situations. IDK. In recent years she’s actually mellowed. She no longer has to bark at every person walking down the street. These days she doesn’t bark at most people. Unless they’re running or riding a bicycle. Conversely, I don’t recall her snapping at people the way she does now. Or maybe I just never saw her interact with so many others. People like mom’s gardener Marteen, or my neighbor Laura, can approach Tiki slowly and she tends to be fine with that and lets them pet her. But when kids reach in quickly, she often snaps at them. And when nurses, or almost anyone, gets anywhere near mom, Tiki reacts aggressively.

animated gif of mom feeding Tiki

Separation Anxiety

Tiki also suffers from separation anxiety. I think this has probably been true for a very long time. When mom used to leave her in the kitchen behind a wooden gate, she clawed half way through a 2″x1″ wooden bar of the gate. How many hours of desperately clawing that represents, I can’t even guess. I had some visitors from Latvia last week and they reported that Tiki was wrought with anxiety the whole time I was gone. She clawed at every door, howled, and was miserable. Vineta said that really, I should never leave the house, or if I must, then take Tiki with me.

In a sort of upside down good news, I guess that once mom goes home, she probably won’t be going out too much right away. But presumably she will eventually, and if she does manage, CareMore notwithstanding, to stay at Park Regency for physical therapy and occupational therapy, then Tiki could be here at my place for some weeks still. In a quick search there seems to be a fair bit of information on dogs with separation anxiety. I’ll have to dive into that as soon as I can.

handwritten list of questions from mom's therapist at Park Regency for her orthopedic surgeon Dr. Kourosh Kevin Shamlou, M.D., Q.M.E.

3/10 Orthopedic Surgeon

Mom had another visit to Dr. Shamlou today. He took the sling off her right (shoulder replacement) arm and said it was time to begin aggressive therapy. That’s good news. Although in mom’s 1st day of Occupational Therapy (upper body) it was extremely painful and she could only move a little bit. Still it is progress.

3/11 Mobility

Mom’s mobility or bed mobility had really improved a lot in the last 2 weeks. She’s out of bed and in her wheelchair all day now. She can get from the bed to the wheelchair by herself. She can go to the bathroom by herself. It’s humbling to appreciate what a relief and how empowering it is just to be able to go the bathroom by yourself and not have to call and wait half hour for a bedpan.

Medical Costs

  • For the slightly less than 2 block ambulance ride from St. Thomas Aquinas church at 1501 S. Atlantic Blvd, to the Monterey Park Hospital at 900 S. Atlantic Blvd, the city of Monterey Park is charging US$1,859.55
  • For the 3 or so hours that mom waited at the Monterey Park Hospital before she was taken over to PIH Downey, The Monterey Park Hospital is charging US$10,740.00

It’s a bit leveling to realize that your entire annual income would barely cover a few days at the Monterey Park Hospital. Even if they didn’t do anything.

March 13th, 2016 by