July 15th-2014

Medical Dilemma: Mrs. X lives alone and has a 24 hour CG who lives with her to assist with her daily activities. Her son is her power of attorney. I arrived at the patient's home in the morning and saw patient making her own coffee. when asked why she is doing that, patient said that her CG was not there all night and she was alone. After some time CG arrived and said that patient has memory issues and thinks that nobody was there. It was hard for me to know the real truth. If I give the CG a benefit of doubt, then I am placing patient at a risk. If I assume that patient is telling truth then I don't know if I am blaming a sincere CG for something she hasn't done. I finally called son and asked him to install camera in house to be fair both to patient and the CG

9 to 5 job for my 89 year old:
Met this lovely gentleman who tells me that his Full time job at his age goes as follows:
To give you the background, patient's wife lives in an assisted living facility 5 mins away from patient's apartment. she was moved there 1 year ago as she needed a lot of assistance due to medical problems and patient was unable to take care of her. Patient wakes up in the morning, has his breakfast and is there to see her at 10 am. They spend some time in activity center, takes her to dining room for lunch. Since he cant eat there everyday, he drives around and gets a quick lunch from a fast food place for himself, comes back to her. Both of them rest in her room and take a short nap till 3:30 pm. after which it's time to wake up, take medications and get ready for dinner. He stays with her till she gets dinner. takes her back to her room. the caregivers get Mrs. A ready and he gives her good night kiss and he leaves after she sleeps. After leaving from the facility, he picks up his own dinner or eats outside, get back home, finish few home chores and goes to bed. Next morning same routine starts. He has been doing this for 1 year and wish to continue till he or she passes away as he told me. Patient had medical problem in his rt forearm and was hospitalized for 3 days. After being back home, he was not able to drive. He was sad that he hasn't seen his wife for a week now and is eagerly waiting for his hand to heal so that he can start driving and go back to his much awaited 'full time job'.

'My 6 year old must be an angel'
A patient of mine with multiple sclerosis. Lives alone and has some care giver who helps him. It was going to be my daughter's 6th birthday party, as I mentioned that he had a big smile on his face and said' she sure must be an angel, Have fun at the party'. He couldn't stop talking about his 5.5 yr old son with cerebral palsy who died after struggling from multiple medical complications. Because of a disabled kid at home, wife turned to drugs and they ended up divorced. He paid a substantial amount to get custody of his 2 kids. after the divorce, his younger son died. He took care of his only son and raised him alone. While talking this story his words which hurt me most was' The pain of losing a kid is the greatest. The pain I am going through right now is nothing compared to that'. I had to struggle to stop tears coming to my eyes, coz I was sure that it would make him sad as well. Now I know why he said ' that my 6 year old must be an angel".

Quote from one of my patients: ' Who said that life will be easy? But it's worthwhile to have challenges'. This patient of mine has severe arthritis and is progressively becoming so weak due to pain that she is becoming dependent with transfers and is getting wheelchair dependent. We are trying hard to keep her mobile. sometimes she loses hope and said' sometimes I feel that if God loves me then Why does he give me so much pain?" but then she repeats the above quote. Today morning she was weak and could hardly move in bed, few words of encouragement made her walk 50 feet... She definitely won today's race. She will see what tomorrow has in stored for her.

#2: patient who was as independent as any of us was made WC bound when he had his hip fractured. He needed 2 people assist to move him. We started working on him,, taking each day as it comes. in 1 week he progressed well and is now walking with assistance. He was ecstatic as he never thought he will walk again. Had a good feeling on my way home thinking about different challenges people face everyday.

A wheelchair bound patient who has frequent bladder infection and now need to use urinary bag which needs to be attached to abdomen/ leg under her clothing. Patient used to use belly bag and has ran out of those bags and niece ordered the small bags which needs to be attached to the leg. Patient had difficulty with walking/ moving the leg as it pulled on to the catheter and caused pain. Patient was told by DME supplier that the belly bags were discontinued and is no longer available. I looked it up online and they were available at few places. Hearing this news the patient started smiling. was full of joy. She started praying to her lord, in her words," My lord, Thank you for sending my PT today and thank you for providing me with the urinary bag.. giving me hope and letting me know that you are always there with me'.
Niece called back after I left, happy and stating that very few people can make her aunt happy and smile and I was one of them. That surely had a smile on my face.

God helps those who help others

Met a retired social worker who lives alone and was hospitalized recently following ulcerative colitis. Patient used to receive meals on wheels for food, however after her recent hospitalization she is restricted in the type of food she can eat so she cancelled her meals on wheels service. Meals on wheels is a non-profit organization who assists elderly people who can't prepare food or doesn't have a reliable source of either friends/ family who can help manage patient's meals. In spite of knowing that meals on wheels have a waiting list and knowing that once if she cancels there is a possibility that she may have to wait for a while before she will be enrolled again. She said" Being a social worker,  I have seen so many homeless and poor people and have seen what food means to a lot of them. When I know that I am not going to eat the food which meals on wheels deliver, it will be wrong for me to continue the service when I know same meal can benefit another needy person. There is somebody who will value this food more than me at this time.' Today she is not driving and she relies on her friend who assist with getting grocery. I offered help and she gladly accepted it. I felt proud to be of a help to a person who has high moral value. I drove myself to HEB and bought her yogurt/ Bread/ grocery items which will last for 1-2 weeks. She was happy and couldn't thank me enough. I responded that good things happens to good people, all her life she has helped people who were in need so God will make sure that there is somebody who is there for her now that she needs somebody.

Small challenges we face in our daily life is nothing as compared to huge calamities few of us are facing. My everyday experiences with my patients just makes these beliefs stronger. Met an amazing couple, with husband being a 42 yr old paraplegic. Living way beyond their means, still not wanting to accept help from others coz even though they do not have any money or good health they have each other. Wife waking up every 2 hrs at night to change his position so that he doesn't develop any pressure sore is what I call LOVE. Eyes were filled with tears and heart with joy for they have rediscovered true love in midst of this hardship.

94 yr old patient of mine. Sweet as she can be, who lives alone and still manage to get by with severe leg pain that she can hardly walk. Room was packed with boxes of toys and candies which she is preparing to gift for christmas to kids( Homeles and disabled). Love to meet such wonderful souls.