Progress Report (finally!)

by Bernard Brandt

Yes, there is something of a contrast between the good news of the title of this entry and the somber note of the video clip which begins it. But if you will continue to follow this entry, dear reader, all will be revealed.

When I entered Beth into hospice care and ultimately into the convalescent home, it was with the understanding that the anti-cancer drug, and the synthetic thyroid that she had been taking, would be continued as a part of the palliative care that she had been receiving.

It appears that the hospice organization has ‘altered the deal.’

I am now told that she will be given neither drug when the prescription runs out, and that hospice care has proceeded from ‘palliative care’ to ‘end of life’ care. Remember all that talk about ‘death lists’ if Obamacare went through, and how the media portrayed this as paranoid delusions?. Well, as the Reverend Wright has said, “The chickens have come home to roost.”

And, as I had to assign Beth’s MediCal and Part D prescriptions to the same hospice care, the prescriptions of her doctors before are not covered by her disability Medicare. In consequence, the Synthroid has gone up from $4.00 per month to $16.00 per month. And her anti-cancer medication has gone up from $4.00 to $300.00 per month. I could financially handle the first change, but not the second.

Fortunately, however, the generic version of the anti-cancer drug, if bought through an online Canadian company, costs perhaps $26.00 per month. I can do that. And I will. And if the people at either the hospice company or the convalescent home won’t administer these drugs, I will.

But more importantly, there has been a change in Beth, and for the better. Yesterday, or Sunday, and for almost as long as Beth had been in the convalescent hospital, she was constantly crying out, either mumbling incoherently, or telling me how the hospital staff was conspiring against her. We had a couple of mutual friends visit her, and one of them had to leave, because it was too painful for her to see the difference between what Beth had been when healthy, and what she had since become. Often, she would not be able to complete a coherent sentence. I remembered how much the same thing had happened when she was in the hospital, when she was overmedicated with morphine, and when they were continuing to administer the mood altering drugs that she had needed before she went into hospital.

Late yesterday night, I received a call from the convalescent home. They asked me if I would approve a temporary measure in her medications, so that she would be able to sleep, and so that the home staff could get some peace. I approved the changes, but said that I would be there tomorrow.

When I arrived at 11:30 a.m. today, Beth told me “I’m really sorry that I’ve put you through all of this, but could you please help me?” The Beth that I loved and knew was back! We talked, and while she still had some strange ideation, she was able to listen to me. I was also told that there would be a psychiatric doctor there at around 1 p.m. Actually, it was nearer to 1:30 p.m., but the doctor came, with a retinue of six or so third year medical students. He said that he was a geriatric neuropsychiatrist from a local university, and he asked my permission to have his students there to review Beth’s case. Of course, I granted permission.

The doctor conducted a gentle examination of Beth, and I was there to add context to her answers. He asked whether she was depressed, and she answered,”How do you think anyone would be if they had to be here?” I thought that a very good answer.

After he completed his examination, he and his retinue went to the center of the convalescent home, where the telephones were, and spoke with the doctor on call. He recommended a number of changes in medication so as not to conflict with the morphine she was receiving. When I went back to Beth, she asked that I return later.

I did so, at about 7:00 p.m. For the first time since her entrance into the convalescent home, she asked if I could read to her. I did so, (an Ann McCaffrey SF novel, if you must know) until she fell asleep at around 8 p.m. As visiting hours had ended, I had to leave.

But at least I have Beth back, for whatever time remains. And that is progress, and of the very best sort.

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