Part two- the emergency room

Mrs. T. had been in and out of the psychiatric building numerous times in 2018. This was  mostly because of off a rapid decline in her dementia/Alzheimer’s after almost 10 years of slow decline following her initial diagnosis. The struggle of maintaining a semblance of our normal life then centered around things beyond memory loss. That began to include episodes of dangerous wandering, and finally going beyond frustration to anger, agitation, assaults and extreme violence. Weeks of what she called the lockup or prison were intended to find medications that would control or limit those behaviors. For those of you who may be unaware of all this there are stages of this awful disease but in the end every victim can be different. My mom  who also had Alzheimer’s simply, quietly faded away. For many the ride is often like a roller coaster things get worse, then temporarily they get better and so it goes.  the last time Barb came home after three weeks of treatment I still had hoped for respite. The next morning she had relapsed once again. After three days and little sleep a friend called and asked me how I was doing. I replied with a single word,” horseshit”. He said " I’ll be right over and take you and Barb to the emergency room. It was 30 miles away. I planned to sit in the back to try to keep Barb calm and prevent any aggressive behavior towards our friend the driver. She wouldn’t do it. Of course, because of the nature of things the caretaker is often perceived in these moments  as the enemy. She sat in front than next to the driver.

I was quickly reminded when our boys were small and not feeling well we often took them for rides. They had a calming effect. That’s exactly what happened in this case. Upon arrival at emergency in the big city we were quickly signed in and told to wait in a large waiting area. There must’ve been over 100 people waiting in this area as well. It was then I happened to notice a very large sign proclaiming the mission of the clinic and its hospitals. The large words stated …… The patient comes first.

After a relatively brief wait two women approached us and said “hi Barb, it’s time to go see the doctors.“Then Barb stood up looking quite peeved saying ”I’m not going anyplace to see those F$%(@ing doctors. They’ll put me in a nursing home!" And so it went and a large audience grew due to all the excitement.  Finally I was told she could not be admitted since she didn’t agree to the plan. I pointed out she had been there in the hospitals psychiatric lock up three days before and perhaps they could call that department and get her admitted. That couldn’t be done either but it was suggested that I call the Police Department and they could presumably bring her in to see the doctors. I suggested this was absurd and I wasn’t going to call the police. I actually thought of calling the local newspaper but then remembered I had never read an article in  paper that criticized the world famous local clinic/hospitals for anything.

Then a break occurred which included the two nice ladies saying they would have to check with their supervisor. They did. Shortly thereafter, a gentleman in suit and tie approached me in a calming manner and repeated the usual excuses and bureaucratic jargon to which I responded in a somewhat loud and agitated manner which I will not repeat here. And the audience grew. This was good. Eventually I put my best smile on and leaned a bit towards him saying ”Sir,

 I might have a solution to your problem” “Mmmm” What ?  Perhaps your people could bring out a wheelchair and set it in front of me and my wife.. I will sit in the chair and if they happen to mention it’s possible this guy could be having a heart attack….”  Ok that’s not good but I was desperate. So it happened that is I sat in the wheelchair which Barb quickly grabbed and pushed me down a hallway and into the emergency room. Where I suggested they break protocol and call Dr.*&^%   in the psychiatric building.   15 minutes later he appeared and took Barb back to psychiatry.   Three weeks later with another round of different meds Barb was moved to memory care in the same city where I visit her each and every day, sleeping well at night myself knowing she has a new and safe home. Our operating motto remains Were still a team, and we keep on trucking.

Protecting your reputation is a key to the reputation of many a big bureaucracy.

Next: memory care lays down the law -part three a bureaucratic basics

Bureaucracy 101 – Troutbirder rant part one

Perhaps a few of these bureaucratic insights came from a college course in sociology I took at the University of Minnesota. However, most of my  bureaucratic applications developed from experiences gained as a result f Mrs. T’s dementia. Specifically, involving a very large clinic and hospital  and secondly a memory care unit. The first ones motto is the patient comes first and the second one who provides assurance that they will keep your loved one safe in their memory care facility.

1.       Bureaucracies are ancient. Possibly going back to the Roman legions who fairly consistently beat my Germanic tribal kinsman. That was simply because they had levels of command and assigned tasks at each level. In a word, the German tribesmen individually may have been fiercer warriors. But they were not organized nor well trained as in professionals.

2.       The most ancient current bureaucracy is likely the Roman Catholic Church. It has had an autocratic chain of command, probably since the first pope took up the mantle of St. Peter.

3.       Bureaucracies today are the people machines that makes modern industrial civilization possible. They organize people in hierarchies  of jobs and authority. Without them we would probably be back in the dark ages. And our wars would be much less devastating.

4.       Bureaucracies can serve many purposes as governing bodies, corporations, churches, armies, and most things in between. Bureaucracies also have many goals commensurate with their purposes. To save souls, to fight wars, to create wealth, to help the poor, to fight disease and so on endlessly

5.       Again bureaucracies often have worthy goals but sometimes they forget them and fall astray. A few examples include protecting their upper management, protecting the institutions reputation, and most frequently their bottom line profit regardless of anything else. Their protocols or rules  often provide structure and clarification throughout the system. As the organization increases in size so do the rules. Laws passed by governments add to the mix. These may serve an important and useful purpose in protecting the common welfare of citizens. This is also where lawyers play a large protecting role for bureaucracies. Their job protect bureaucracy itself. That is to say whether its goals might be open or closed legitimate or otherwise. Often the rules are what  used to be called “red tape”.Red tape is an idiom that refers to excessive regulation or rigid conformity to formal rules that is considered redundant or bureaucratic and hinders or prevents action or decision-making. It is usually applied to governments, corporations, and other large organizations In medically related institutions the word protocol often comes up.

6.       Well, I’m sure by this time you figured out that I have an ax to grind. Plainly it involves some personal examples involving Mrs. T’s safety and care. I’ll begin by noting very seriously that she has in large measure been treated well by large numbers of caring compassionate and professional people. She has beaten two different kinds of cancer in the last two decades and my own life was saved after a near death experience from a drug now banished by the FDA. In a similar manner, I also have a very high opinion of the lawyers who took on my case against  the biggest of the big Pharmas.

Next: The day they wouldn’t  admit Mrs. T into the emergency room.

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No Fishing

I haven't  gotten out flyfishing as much in recent years as I have in the past. There were several reasons for this but  the main one initially was my slowly increasing vertigo.  Falling in a fast-moving Rocky trout stream was a recipe for disaster. As Mrs. T's dementia based wondering and agitation grew, it all fit together. Instead we took up Woodland walks. It's it was quiet... really quiet except for the birds having there spring fling. Warblers everywhere. And others almost beyond counting. What a setting. Take a look.



I don't think having a large GSD dog romping around thru the woods in front of you is standard birding technique. Still, years of upland game hunting for pheasants and ruffed grouse made it seem quite normal to me. Baron  flushed the tiny birds and they often flew in my direction as not.  I knew where to look for them with my binocs as they landew in nearby trees.

I watched carefully when he startsed sniffing the ground too carefully. Chasing deer is not acceptable. Then, as he and I learned later in the fall, investigating skunks isn't so great an idea either.

These crystal clear, cold streams, orginate from springs. This limestone (karst) region is full of disappearing rivers, caves, sinkholes and bubbling springs. Here is one in a nearby state park. Water cress is often an indicator of such a spring.

 We came a spot where two streams joined. The water   deep . Baron swam across and looked back expecting me to follow. Fortunately their  an old abandoned bridge, which carried some long forgotten road. Now it allowed  to easily reach the other side.

I did see some nice brown trout along the way.  In the meantime, we headed back to the camper. Mrs. T. mentioned something about  hot dogs for dinner. Come on pup. Time to go.

Acid Reflux

Today’s adventure story will be of a medical nature, the dreaded acid reflux, also known by some as heartburn. For me, it all began perhaps 40 some years ago when describing certain symptoms to my family care doctor he said it was acid reflux. He also noted it could be precancerous and sent me to WFMC…… World Famous Mayo  Clinic. They concurred. Thus began a seemingly lifelong regimen of famous pills both prescription, over-the-counter and other antidotes. Also there was the low acid diet which eliminated among other things tomatoes from my life. Goodbye pizza and spaghetti. In spite of all this there were still bad spots for me as when on Vancouver Island in Canada I ran out of Nexium and prescription drugs could not be filled for reasons too complicated to remember or explain. The symptoms were extreme enough that Mrs. T had to do the driving as she raced us in only two days back to the state of Washington. So it went.

Much more recently,  as her Alzheimer’s dementia began to reach the drastic stages, my physical reaction included a lot of stress. My new primary care doctor prescribed a pill for anxiety. I followed her advice, took the pills as well as  went to another visit to Mayo Clinic to check  my worsening acid reflux.

 

It was in the gastroenterology department that a day and one night at home test revealed that I didn’t have acid reflux. I asked the consulting physician how all that could be possible after 40 years of doctors and pills saying I did have it?   Mmmmm.? Will get to the bottom of it, he said Now I’m involved in the mystery but the eye, ear, nose, and whatever department will help sorted out. More tests including a camera down my throat to take pictures. A day later reporting to the consultant they had the definitive result.

“You have acid reflux” he said. I won’t be smart this fine clinic which saved my wife’s life twice different cancers and mine once from a near fatal drug reaction but I did momentarily laugh and suggested they call me when the two departments resolve their differences.

I do know that apparently Mayo sometimes withdraws all the medications from some of their patients who have mysterious ailments. Back to the starting point as it were

Conclusion: I made that decision myself to no longer taking any meds of any kind related to acid reflux and  gave up my acid-free diet as well. I no longer have any symptoms of acid reflux and enjoy my orange juice for breakfast and the occasional pizza for lunch :-) I’m sure there is a moral to this tale but I don’t know exactly what it is. Perhaps you do. In the meantime, I’m off to see my beloved at Cottagewood. The food is really good there and I eat whatever they serve and help my wife to eat as well.

Pope & Young & Me

It all started with an invitation to join Mrs. T.
and her teachers sorority for breakfast at the Pope & Young museum in Chatfield MN "What's Pope & Young," I had asked, looking for an excuse not to go. "I don't know either", she replied but Jewel said Steve is going so....



"Ok," I replied not too thrilled.


The breakfast was decent, the museum tour was terrific.
Pope and Young turned out to be a national bowhunters
club dedicated to conservation and record-keeping.
Similar to the Boone and Crocket club for gunners.
The museum had the history of bowhunting in dioramas and other exhibits.








Saxton Pope and Art Young are the two gentlemen who are synonymous with the bowhunting revival that began near the start of the 20th century and continued through today. The images are taken from original lantern slides from the St. Charles Family Archery Collection.


Of course, I was thrilled to relive my boyhood memories of Fred Bear hunting the polar bear with his bow and my Ben Pearson long bow. In my youth, I had proved to be an adept hunter of squirrels and rabbits. And then I couldn't help but remember my first years bowhunting the elusive Minnesota whitetail.

It all began my first year of teaching in the Valley. Several veteran
bowhunters, Don and Jerry, invited me to join them for the fall deer
season. They were my mentors in this exciting new sport. I knew there
would be no "buck fever" for me because well... I was Mr. Cool.

Several outings produced no opportunities. Then my big chance came
on a Saturday morning near Lanesboro. I had been placed at the head of a steep gully about fifteen yards above a small spring. My hunting partners fanned out to either side after advising me that any deer would surely come up the ravine on their way to the spring. I was situated behind some bushes and directly in front of a large log.

It was still not quite light when I assumed my standing position. Ready, willing, and able to take my first deer. Soon every little sound in the forest got my attention. I was sure a number of times that deer were
approaching me from behind.... only to find, upon carefully turning my
head, that it was squirrels, grouse, chipmunks and other woodsy
creatures. No deer though, for hours. Finally, after several hours, I decided
to sit down on the log, where I could still see the spring ahead and down to
my right. The bushes concealed my vantage point.

I never heard them approach me from the left. There were three deer which I saw out of the corner of my eye.
Paralyzed, I never moved. The lead deer stopped not five
feet in front of me on the other side of the bushes. Then she turned her head, lowered it slightly and stared right at me.
Now what do I do?

I swear every time I blinked she seemed to stare harder. The standoff lasted an eternity. Every time I slowly tried to stand up and get my bow ( which was
laying across my lap) into a vertical position she twitched.
Finally, I decided on Plan B. I would lift my still horizontal bow
slightly, draw the arrow, and shoot her straight thru the bushes.
At five feet, I could hardly miss. I slowly began to draw the
arrow back, reaching about half a draw, when the string
ran into a large obstacle.... my stomach.

I could have fired. Probably having the effect of a small mosquito bite. About that time I also noticed several more deer gathered around the spring. I picked out the largest and went for the stand up quick shot. At my first
motion to stand up, the deer on the other side of the bush let out a loud "woof" and immediately all six deer scattered in six directions. I never got a shot off.

I bowhunted a few more years after that but as my friends had moved on to other school districts, I found it was the cameraderie of the hunt that had been most appealing. Thus ended my deer hunting years although I continued with upland game and waterfowl but those are other stories.

Back in the day when I was growing up my father and all his brothers called it The Shakes. More recently my neurologist identified the problem simply as Benign Familial Essential Tremors. Lucky me! I call it  annoying. The Golden Years have begun. It’s clearly not fatal the experts told me and it likely won’t get worse. It did though to the point that holding my head still, keeping my arms and hands steady and drinking a cup of coffee without spilling became a major problem. Also other problems include, using a camera, holding my binoculars for birding still and even typing (now called word processing). So what to do?

The experts recommended testing various epilepsy pills. Thanks a lot. I got some bad headaches. Finally, I decided to adapt. Plainly filling the coffee cup only half-full or using a straw seemed a reasonable adaptation. Then I discovered Kwick Trip Coffee. It seems the miraculous lid has a small opening which allows the drinker to cover it with his mouth thereby preventing any spills. Amazing!

 

That was followed by a telescope sitting on a tripod for birding. And best of all my computer guru Brian added the Dragon to my computer. The Dragon quite simply listens to me talk and it types what I say. I could email and blog again.

Wow with that positive note all stop for my morning coffee and six boxed doughnuts for the ride up to Rochester and Cottagewood memory care. If Mrs. T knew of my morning diet I'd definitely be  in trouble. Actually though my real danger in the morning is not my bad diet but the fact that thousands of Iowans are racing north, passing on yellow lines darting in and out and all because there late for work at Mayo Clinic. This happens on a two lane narrow curving highway with lots of small dips. This definitely places a safe driving cautious law-abiding Minnesotans in serious danger. Of course, they do the same thing later in the day when they're anxious to get home.
Catch you later dear friends, I'm looking forward to a good day
 

A Foggy Morning On The Beach memoir

With thanks to Nathanial Hawthorne - "This is the forest primeval. The murmuring pines and the hemlocks,Bearded with moss, and in garments green, indistinct in the twilight,Stand like Druids of eld, with voices sad and prophetic,Stand like harpers hoar, with beards that rest on their bosoms.Loud from its rocky caverns, the deep-voiced neighboring oceanSpeaks, and in accents disconsolate answers the wail of the forest." It's early morning, cold and damp, as we walk carefully toward the distant roar of the Pacific. The forest of hemlocks is mighty and tall indeed. Strangely though, the closer we come to the beach, the trees shrink in size.

The coast is guarded by a phalanx of beached logs. We head down the beach as another couple leads the way.

Early morning, when the tide is out, is the time to find those washed up "treasures." We wander about a bit.

But today it is not meant to be. Mrs. T begins to signal its time to head back to the car.

The fog begins to clear as the sun peeks thru the forest.
In the morning light, the density of this temperate rainforest is more obvious than ever.
As my "Evangeline" and I approach the trailhead and our car, I notice for the first time, signs proclaiming the forest to be inhabited by wolves, mountain lions and bears.This is the forest primeval indeed!