Medical

Thanksgiving lunch, mulch experiment and outside kitten progress

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Lats this morning I headed over to my mother’s place with a turkey dinner to have lunch with her.

On the way out, I spotted three sets of ears in the window of the cat shelter.

Tiny sets of years belonging to the little kittens! I didn’t dare go closer for a picture, though, because I didn’t want to startle them away. There may have been more cats inside with them that I couldn’t see, too. I’m so glad to see them in the shelter, rather than hiding under it!

My mother and I had a very nice lunch and visit (how visits turn out is always touch and go with my mother! LOL). I brought a mask exemption card to tape to her door, and another she can carry with her. Hopefully, that will help reduce the harassment from the caretakers. Unfortunately, I think more has happened than she is telling us, because she kept insisting she “doesn’t want a war” and even started asking me not to call the housing department responsible for her building to talk about the caretaker’s abusive behaviour. She wore a mask – under her nose! – to meet me at the side door that’s very close to her own apartment door, and even in that short distance, by the time she was back in her apartment, she was struggling to breathe. She had also mentioned to me on the phone, waking up and struggling to breathe again. So I brought a foam wedge we got for my husband that he ended up not being able to use. Depending on how it’s positioned, it can be used under the knees, to lean against while sitting up in bed, or to sleep in an inclined position. The doctor had recommended trying to sleep more upright to see if that helped. When she saw it, however, she flat out refused to even try it and told me to take it home. Eventually, she said it was because it looked ugly! Which I highly doubt is the real reason. Frustrating!

Still, it was a good visit and my mother was very happy I was able to come over. I think the pandemic social restrictions are really getting to her. There used to be many events and gatherings, either in her own building, or in nearby venues, that she attended. Now, there are none. It seems the only real “social” interactions she’s getting these days are with the nasty caretaking couple. The restrictions seem to be bringing out the worst in people. I think she is getting very lonely, and some serious cabin fever!

Once at home, I took advantage of the warmer weather. With the garlic ready to be picked up when the post office opens tomorrow, I was thinking of how I wanted to mulch the beds. The straw is not breaking down as I had expected, and I decided to try an experiment.

Using the new push mower to chop it into smaller pieces!

The bag filled up very quickly, but it wasn’t until I had already started that I realized I’d forgotten to check the height of the mower. It was at 7; the highest setting! So things weren’t quite as chopped up as I wanted.

I lowered it to 3 and that chopped things up much better.

It took only 2 bags to fill the wagon, it’s so fluffy. LOL I laid out a tarp near the beds the garlic will be planted it, to make it easier to work with when it’s needed – plus I can fold half the tarp over the pile to keep the wind from blowing it away.

Unfortunately, I had an unexpected problem.

The new lawn mower stopped starting.

Right from the beginning, it was harder to start, but every time I had to turn it off to empty that bag, it kept getting harder to restart it until, finally, I just couldn’t start it at all. It had been so easy to start, before! In the spring, when we had so much rain, I was using it a lot and had no problems. Then the rain stopped, and the grass never really got long enough to make it worth cutting again. So it’s been sitting in the garage for the last couple of months. That on its own should not cause the problem. I couldn’t find any reason for it. It just won’t start. After getting only 2 1/2 wagon loads done, I finally gave up.

I will just have to take it in to the small engine shop in town to get it looked at, later in the year.

So the experiment worked, as far as chopping up the straw to make a finer mulch. It was just the lawn mower that failed!

After giving up on that task, I took the time to take the sun room replacement door off in preparation for painting the frame. I plan to get at that as soon as possible tomorrow morning, then go to the mail to pick up our bulbs. I will get the garlic in, while the girls will be doing the digging to get their flowers in.

While working at the door, I spotted this.

That is two little kittens in there! One of the orange tabbies, and Creamsicle Jr. As I walked around after taking the picture, Potato Beetle came out of the entry. I hadn’t seen him at all in there!

So I decided not to go inside after taking the door off, and stayed to see if I could get the kittens to play.

I had a target in mind.

This little lady. In the interest of trying to reduce future litters, we are hoping to get her friendly enough to bring her inside.

Yeah. I know. We have too many cats inside already!

Nostrildamus, meanwhile, couldn’t get enough attention! It was only a couple of weeks ago that we were lucky if we could pet him at all. Now, he’s all over us, asking for pets! He still doesn’t like to be picked up, but he does like chewing on fingers!

The two napping in the shelter eventually came out to see what was going on, and joined in on the play. I was able to pet the little orange one – the smallest of the 4 younger kittens – and even managed to pet Creamsicle Jr. a bit. The calico, however, would not let me touch her! However, my daughter came out to join me for a while, and she tried to play with them. Not only did she get the calico close enough to pet, she was even able to pick her up! Only briefly, and she didn’t like it, but she didn’t run away after jumping down, either.

Aside from Nostrildamus, we seem to be having a better time of socializing Butterscotch’s second litter than the older kittens. Though it didn’t help that Butterscotch was around and growling all the other cats away, including her own babies!

Still, we have made some socialization progress!

The other little orange kitten came by later. That one, the gender is still in doubt, but from what little we’ve been able to see, I suspect it is female.

I thought it was supposed to be rare for orange tabbies to be female, but here, they seem to be the majority! Of the older kittens, Nostrildamus is the only whose gender we are sure of. His one confirmed sister is now inside, but with the luck we’ve been having, his other sibling and Rosencrantz’s baby are also female! And we can’t get anywhere near any of them. :-(

Ah, well. We will just have to do what we can. Mostly, I’m just really, really glad the little kittens are going inside the shelter.

The Re-Farmer

It wasn’t supposed to rain today

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All the forecasts showed the rains would be passed by this morning. Instead, we’ve got three large systems heading over us.

Which meant the cat food containers I put by the cat house were full of water.

At least all the food that was in them was gone, first.

I dragged over the saw horses and made them a quick shelter.

I reached into the cat house to grab the container in there to fill, but it was gone. Not just pushed back, almost out of reach, as I’ve found it before. Nope. Completely gone!

There was another container that I’d had that disappeared. I figured it got pushed under the cat house, but with this one completely gone, now I wonder!

The girls heard skunks fighting last night. I wonder if they could have dragged them off? Is that a thing skunks do?

Hopefully, the rain will be done by this afternoon, when we’re supposed to have quite pleasant temperatures. We were going to put the sheets of insulation around the bottom of the house today, as well as cover the septic tank for the winter, but we’ll see how wet it still is.

Well, now… The phone rang while I was writing this. My mother called to let me know she found a note slipped under her door, saying “your daughter has to wear a mask.” When I brought up medical exemptions, and that she shouldn’t be wearing one, either, she told me that they don’t understand that. She doesn’t want trouble, so she wears one and just pulls it away from her face, or under her neck, when she can’t breathe.

*sigh*

That is a problem to deal with another time! For now, I need to head to town to pick up a prescription refill for my husband, at the pharmacy where they are more sane about things like this!

The Re-Farmer

Unexpected

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Oh, what a day this turned out to be. I’m looking at the time and wondering why it’s not several hours later, because this day has felt much longer than normal!

But first, I share the pleasantly unexpected thing.

As I finished up my outdoor morning routine and headed for the house, I noticed something white in the window of the cat house.

Plus, something moving in the shadows behind!

Unfortunately, my coming closer startled the cats. You can just see a hind leg of mystery kitten, who dashed out as I got closer. Little Braveheart was still in the window, and I was pretty sure it was Tabby that I saw in the shadows.

Then, the Creamsicle emerged!

Creamsicle was the first cat I saw checking out the new shelter, and I’ve seen Tabby lounging in the window. I’ve seen other kittens coming out from under it, but this is the first time I’ve seen Mystery or Braveheart inside, and the first time I’ve seen more than one cat in there. This is very encouraging. I know, in past winters, even cats that didn’t get along would still join the pile on the swing bench to keep warm, but it’s still great to see some confirmation that they can use the new space peacefully together.

What I am really hoping to see if Butterscotch’s babies going in there! They are so much smaller and younger, they are the most as risk from the coming cold. Weather Canada is forecasting a long fall and late starting winter, though. I hope they are right, because I’ve also seen forecasts for an early, long and bitterly cold winter coming up.

Meanwhile, the predicted rains last night turned out to be a brief but wicked thunderstorm, complete with driving rain, thunder, lightning, high winds and – no surprise – losing our internet. Thankfully, we did not lose power. As I write this, in the early evening, we’re still at a very warm 25C/77F!

Among the things I needed to do today was head into town and pick up my husband’s prescription refills. Even with a box of insulin, thanks to his excellent private insurance plan, the grand total is rarely more than $100. Last month, his refills happened to include both his injections and needles, and for the first time since things got messed up with his restricted painkillers, his bubble packs had all of his medications in them. So it was quite a shock, but not too unexpected, for the cost to be closer to $300. This time, it should have been less.

It was more. The total was almost $400.

At this time of the month, I simply didn’t have that. The cashier started checking the slips for me and noted that not all of them had the 3rd party payment (what the insurance company pays) on them. With 16 medications, it added up fast.

So I got her to suspend the sale while I stepped aside to look through the slips and then, if necessary, transfer funds from our emergency account. I was perplexed, though. What changed?

I went back to the pharmacists and asked if anything new had been added. The pain clinic doctor was supposed to call our regular doctor and talk medications. Our doctor said that he would fax any new prescriptions directly to the pharmacy. Could that be what happened?

Nope. Nothing was changed. However, according to what was showing up on the computer, we had reached our limit with the insurance company for medications.

Our what???

This has never happened before.

In the end, the pharmacist took back the printed out slips and told me to just take the medications, and come back after we cleared it up with the insurance company. They would rebill the amount then.

Yes. The pharmacy let me walk away with hundreds of dollars of medications without paying for them! Her comment was “we know you’ll come back.” Which is true. There’s no risk to them, since we are regulars, but still… that’s a lot of money walking out the door!

The next several hours was spent alternating between my husband and myself on the phone, with him calling the insurance company first.

In a nutshell, because we now live in a province that has Pharmacare – a provincially run government insurance program – the insurance company covers the cost of the deductible, then stops paying out because the system then covers the rest – but the system didn’t kick in.

As far as I knew, when we sent in an application for Pharmacare, shortly after moving here, we didn’t get accepted. I remember getting a letter asking for my tax information from 2015, when no such information was asked for on the form (my husband and I were both on the one form). I remember getting another letter since then that was basically a giant word salad and, as far as I could make out, we didn’t qualify. So I assumed we did not have it.

The insurance company’s limit on the deductible was only $1500. I called the pharmacy and talked to someone there who looked up my husband’s file, and they’d actually paid out almost $2000, so we were well past the limit. Most confusing of all, according to what she was seeing, is that we were approved for Pharmacare. We had it. But it didn’t kick in when it should have.

She gave me the number to call and find out why.

It turned out our Pharmacare deductible was actually over $3000. Which meant we were on the hook for the rest. The guy I spoke to said we should have gotten a letter back in the spring with the deductible amount. That would have been the letter that I understood as telling us we didn’t actually qualify. He said he would mail us a new one, which our insurance company would probably want to see.

Also, two of my husband’s medications (one of which is the pain killer that comes in slow and quick release forms) are not covered by Pharmacare at all.

My husband then called the insurance company back. Sure enough, once they have the proof in hand, they will adjust the limit to match what our deductible.

I called the pharmacy back and explained it to them, and they are fine with our coming back after all this was done, so they could re-bill the insurance company, and we would be paying only whatever was left. How long that takes depends on how quickly the letter gets to us in the mail (after that, my husband can just email a copy to the insurance company), which could take more than a week.

Our pharmacy is awesome!

If we were living in a province without Pharamacare, this would never have happened. What I don’t understand is why this didn’t happen last year! I guess the new medications my husband was put on after his stay in the hospital was enough to kick it over this year, but he was put on them late enough in the year last year, that it wasn’t an issue.

By the time this was all figured out, my husband and I were both completely drained.

The rest of the day’s plans went out the window.

It’s time to de-stress!

The Re-Farmer

Get a little bit closer, and a follow up

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I headed out to water things this evening, but got distracted.

Junk Pile and two of her babies were out!

I ended up lying right on the ground, in hopes that would make them less intimidated by the tall(ish) human.

Creamsicle took full advantage of the situation.

What a silly boy!

Tabby didn’t come any closer than this, but did spend some time rolling around under the grapes, in between watching me.

Little Braveheart did come a bit closer to the stick I was wiggling, but not close enough to actually touch it.

It was funny to watch Little Braveheart and her mother. They share many of the same mannerisms, and often mimicked each other’s movements.

They also have the same eyes! Even though the markings in their fur are different, they have the same facial structure and many other similarities.

The grapes, meanwhile, did eventually get watered, and are looking really good.

The more shaded ones at the back of the trellis are noticeably darker than the ones that are more exposed.

While tending the rest of the garden, I found this.

The tallest of our sunflowers is starting to open up its seed head! So far, it’s the only one at this stage.

Awesome!!! I can’t wait to see how big the seed head gets.

Meanwhile…

My husband and I had our medical appointments today. Heading out two days in a row was really hard on him. Thankfully, we got in quickly, and didn’t have long to wait.

I learned one thing today that my husband forgot to mention after yesterday’s appointment at the pain clinic. The doctor there was going to phone our doctor here to discuss recommended pain medications.

Another reason I’m unhappy I wasn’t allowed to go in with him yesterday. He forgets things more often, these days. At least he remembered this while with our doctor!

The doctor had a couple of concerns. For one, he will be referring my husband to an endocrinologist, so we’ll be getting a phone call about that. He also wants to adjust my husband’s prescriptions, but will wait until he talks to the pain clinic doctor, go through his current medications, and think about it. Once he’s done that, he will fax any new/changed prescriptions directly to the pharmacy.

As for the rest of my husband’s bloodwork, it was all fine.

Then it was my turn. My bloodwork was fine, across the board. During the physical, we did get a laugh. After testing my reflexes, he did the usual putting his hand on my knee while flexing the joint, as he started to ask if I had any issues with pain, etc. When he lifted my lower leg, he cut himself off in mid sentence with a startled “Oh!!”

To which I responded to his half-finished question, “yes. Arthritis. You felt that, did you?” :-D

Yeah, both my knees do some interesting things when they’re flexed!!

One thing with both my husband and I was, what we thought were heat rashes turned out to be fungal infections. !! So we both got prescriptions for creams to treat that. When we were done, I dropped my husband off at home, picked up a daughter, then headed into town to get the prescriptions filled before the pharmacy closed. A stop at the mail on the way out found a letter from the heart clinic, with my husband’s rescheduled appointment, early next month.

I’ll have to remind him to phone them about it right away, to arrange some sort of accommodations, like having a stretcher available for him, for an appointment they say might take up to 2 hours.

So while nothing much changed at today’s appointment, steps were taken and others are being put in place, for the near future.

We shall see what comes of it.

The Re-Farmer

How it went

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So…

My husband and I are back from his appointment at the pain clinic in the city.

In a nutshell?

Nothing happened, and nothing will happen. At least not there.

To backtrack a bit.

When we first moved here, one of the first things we had to do was find a new doctor for my husband. Just a GP to start with, so he could get his prescriptions refilled, to start with. From there, he could get referrals to specialists, as needed.

Before the move, my husband had a primary caregiver (at first, a Nurse Practitioner, then a GP), a physiotherapist, an exercise specialist, a psychiatrist and, at the pain clinic, a team of 4 or 5 people; I can’t remember exactly how many, but there was the doctor that was “team lead” on his file, a doctor that specialized in medications, another on physical care/exercise, and one or two more that I can’t remember what they specialized in anymore. I might be forgetting another specialist.

It took him a year to get into the pain clinic in the city, but that was only because his paperwork somehow got lost.

Twice.

So somewhere between the regular clinic and the pain clinic, there were issues, but once he got in, things went quickly.

We were hoping to find something similar here, but really didn’t know what to expect.

The new doctor got a referral to the pain clinic in quickly. That was in February of 2018. What we were expecting to get was a phone call for an appointment. As months went by, the doctor would check to confirm, and yes, my husband was still on the waiting list. Then this doctor had to suddenly move, we found our current doctor and saw him for the first time in December of 2019.

When he found out how long my husband had been on the waiting list, he promised to push to get him in.

In February, my husband got – not a phone call, but 14 pages of questions they wanted him to answer. All of which was information that would have been in his medical file. He answered as best he could, but some of it simply went back too far, and we no longer had the details (which would have been in his file, anyhow), while others were too complicated to answer on the form. At one point, my husband even wrote in, “don’t you have this one file?”

Then the pandemic lockdown happened in March.

No more health care, unless you thought you had the virus, or were in an emergency situation – and even those got punted.

So that added another 6 months to the wait. Today’s appointment was almost exactly 2 1/2 years, to the day, since my husband was put on the waiting list.

We made the drive in, and it took about 1 1/2 hours to get to the clinic – about 15 minutes less than I’d expected, but traffic was pretty clear when we came in. (It took longer to get out of the city, later.)

When we got there, I was able to drop my husband off with his walker at a ramp, then parked nearby as he went in ahead of me. At this point, we were about half an hour early for his appointment. Plenty of time to go through the gauntlet to get to where he needed to be.

After I parked and went to follow him (he was NOT required to use a mask, Thank God!), I was told they were allowing patients, only. I could not go in with him.

They did, however, allow me to use their washroom, at least!

The city is even hotter than we are – it was 32C/89F with a humidex of 37C/98C. There was no way I could wait in the van in that heat. So I started wandering around to try and find some shade in the area.

I found some.

There was even a place to sit down.

Sort of.

Thankfully, I still had some waterproof cushions in the van that I’d bought so my daughter and I could sit outside on damp concrete benches to have lunch together, months ago.

By this time, my husband had texted me to let me know where he was, at the same time I was texting him to let him know I wasn’t allowed to join him.

Since it was a while before his appointment was booked for, I took advantage of the time and played some Pokemon Go. I even found a nice, little park next to a Pokemon Go gym I could battle in.

Such a lovely, shady spot.

Sometimes, people really suck.

I’d been playing for a while when I got a text from my husband – well past his appointment time – informing me that he was still waiting.

I walked around for a while longer before returning to the shade by the clinic. By the time I got the message that he was done, it was an hour past his appointment time.

So how long was the appointment?

Well, it turned out to be a two part appointment.

For the first part, a nurse came in to talk to him about his diet and diabetes, while skimming over his file.

He ended up cutting her off to ask if they could focus on why he was there: his pain.

It turns out that some of his pain issues was listed in his file as being diabetic related.

In reality, his diabetes is related to the pain. And the other pains that were noted as being diabetic related are actually from nerve damage due to problems with his spine, which in turn are exacerbated by the original injury.

The nurse left after about 10 minutes. He could hear she was talking to the doctor in the hallway before the doctor came in, and gets the feeling she “warned” the doctor in advance.

The doctor was to the point – which was much appreciated – and quickly ran through potential options.

Surgery.

That was looking into years ago, and my husband is not a candidate for surgery. He explained that, and the why of it, to the doctor.

Shots.

That was in the file as having been tried before, without success.

Physiotherapy/mental coping skills.

It turns out there’s nothing at this clinic as far as physical treatment that he can’t get from any physiotherapist locally. Certainly nothing to warrant the 1 1/2 hour drive each way. There don’t seem to be any of the exercise specialists that helped him before, in this province, in any variation. As for mental coping skills, as a martial artist, my husband was already well versed in the use of meditation techniques they would advise. He’s been using them to help cope with the pain for years.

It makes for very quiet trips to and from the city, as he spends almost the entire time using those techniques to control/cope with his pain during the drive.

That left one more thing.

Medication.

And there is nothing they would do that our GP can’t.

Finally advice?

Go back to your doctor.

Which is what we’re booked to do tomorrow.

On the one hand, okay. This is good. We know what they can or can’t do. Maybe if we lived in the city, there would be more options? I don’t know.

The thing that frustrates me most is that our first doctor would not adjust my husband’s painkillers, or related medications, until the pain clinic saw him first. He had no problem adding more medications for other things, but he wasn’t going to touch the pain issues without that. He was by no means a bad doctor; in fact, he was better than the others we had to deal with when my husband ended up in the hospital. I think he was just too young, inexperienced and lacking in confidence for a file as complicated as my husband’s.

As for our current doctor, he’s seen my husband all of twice, and 1) kick started the pain clinic response in the first place and 2) is already considering alternative medications that might help with the pain better than what he’s on now.

And this is even with the pandemic shut downs slowing everything down.

Which basically means we had 2 wasted years of waiting for my husband’s pain medications to be adjusted, that wasn’t necessary. Plus the 6 months of no health care at all, due to the pandemic shut downs.

We waited 2 1/2 years for less than 15 minutes at the pain clinic, and there’s nothing there to help him.

The van was parked close to the ramp where I’d dropped him off, which was handy, since there was an ambulance parked next to the ramp’s drop off/pick up zone. Still, I wish I could have brought it closer, because I could see he was really struggling.

Then, we went to a McDonald’s, mostly so we could sit in some air conditioning. As hungry as he was, he couldn’t actually eat more than a few fries, as he was in too much pain, but it did give us a chance to catch up on what happened.

Then there was the drive home.

A very quiet drive home, as he meditated pretty much the entire trip.

We still have the drive to the doctor’s, tomorrow, but at least that clinic is only about 40 minutes away.

I do have higher hopes for our current doctor.

We shall see what happens tomorrow!

The Re-Farmer

My favorite mutant

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While doing my morning rounds and picking more squash, I always check on my favorite mutant sunburst squash.

It looks like, where it rests against a leaf or stem (which I’ve moved to take the picture), it turned yellow, while the exposed parts are green.

I find myself torn between wanting to pick it, and seeing if it’s any different on the inside and if it tastes any different, or leaving it to grow, to see how big it gets, and let it to go to seed. :-D

I think I’m leaning towards leaving it. :-)

My husband and I will be heading into the city soon, for his appointment at the pain clinic. I figure it’ll take about 1 hour, 45 minutes, to get there, so we’re leaving 2 hours early. How long the appointment will be, I have no idea. Then there’s going to be the drive back.

This is going to be very difficult on my husband. For medical appointments, he tends to skip his quick release painkillers (which are “take as needed”), so that his mind is clearer. What a choice to have to make: reduce the pain, but be in a brain fog, or have a clearer mind, but with increased pain.

I really hope they can help him get this pain under control. This is no way to live.

With us being gone for most of the day, I’ll have to remember to ask the girls to freeze some of the sunburst squash we’ve got so much of right now. :-)

The Re-Farmer

Following up on things

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I got to follow up on a couple of things this evening.

We hit 32C/89F today, so once things got cooler, I headed out to water the garden beds.

Yesterday evening, after letting the silicon sealant cure for more than 24 hours, I filled the rain barrel by the garden, so today was the litmus test. I’m happy to report, there were no leaks at all at the cracks in the barrel.

With the barrel set up in the shade of a tree, the water in it was actually still cool! But not cold, which I’m sure the squash pants appreciated. Some of the leaves look like they got shocked by the cold, the last time I used a hose to water them.

While watering the beets and carrot beds, I startled a little friend.

It even gave me a chance to get pretty close with my phone to take pictures, before disappearing. This is the first time I’ve seen one of the green tree frogs jumping out of these beds. Gosh, they’re pretty!

While there, I decided to check on my other green friend, in the chokecherry tree by the junk pile.

The caterpillar is still there – and noticeably bigger! If you look at the veins in the leaf to compare between the two dates, you can see he’s quite a bit longer. The colouring has smoothed out, too. I’ll have to check again over the next while; he might get as big as the ones I found when I was a kid!

I’m happy to add that I saw flashes if kittens while making my way between the garden beds. While I was checking on the caterpillar, Butterscotch even emerged from the spirea to say hello and let me pet her. :-)

I’m glad she didn’t move her kittens.

The next thing I’ll be following up on is how things go tomorrow! We’re headed to the city for my husband’s first appointment with the pain clinic. I’m glad it’s finally happening, though to be honest, I don’t have much confidence in how it’ll go. After all these years, I think I’ve gotten way too jaded, but between the 2 years it took for my husband to get a 14 page form to fill out, and what was in the form itself, I am already not impressed with this place.

Mind you, I don’t think I’ll even be able to go in with him. They said he’ll have to wear a mask to go in, without anything about medical exemptions – and he has several conditions that would apply! I already know wearing a mask triggers my chronic cough, so maybe we’ll both be able to get exemptions, but I doubt it. Another reason for my expectations to be very low.

Hopefully, I will be proven wrong.

The Re-Farmer

A little friend, and change of (medical) plans

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While picking cucalmelons this morning, I found a little friend!

We’ve been seeing LOTS of frogs about this size, every time we to go through the garden beds. Usually, they hop off too quickly for me to get photos, but this one didn’t move!

He was even okay with the cucamelon leaves being pulled aside.

I am very happy to see so many frogs in our garden beds. I’m sure they’re doing a great job of eating up things that would be eating our vegetables!

On a less cheerful note, the original plan for today had to change. This was the day I was supposed to bring my husband into the city for an appointment at the cardiac clinic. They want to discuss the possibility of implanting a defibrillator in him.

Unfortunately, about a week ago, my husband discovered cats had peed under his hospital bed, and under the small table with the mini fridge he keeps some of his medications in. He cleaned it up himself, rather than asking any of us to do it.

He still hasn’t completely recovered.

When his pain levels didn’t improve by Monday, he called the cardiac clinic about his appointment. The letter he received said to expect to be there for at least 2 hours. He explained his situation. The choices were to either cancel the appointment, or they could find some way to accommodate his pain levels and disability.

The appointment got cancelled.

They way he put it, the response was along the lines of, how dare he mess with their system.

They will send another letter with a new appointment (I find it interesting that they make these appointments with zero input from patients), and after he gets the new letter, he can talk to them about accommodations. Of course, he has no way of knowing if he’ll have a good day or a bad day – or even a good week or a bad week – that far in advance. That’s why he was stuck phoning them only about 48 hours before today’s appointment. No matter; even if he’s having a good day, being able to lie down on a stretcher of something would probably be needed, just after such a long drive.

I understand why the province has a single cardiac clinic in a central location. It is probably much more efficient, and allows for things like better access to equipment. The problem is, like almost all Canadian provinces, we are geographically huge, and not everyone lives in or near this particular city. We’re just an hour away from the city (though it can take another half hour to reach the clinic, depending on traffic), and it’s difficult enough. I can’t imagine living in one of the fly-in communities and needing cardiac care. Sure, the small communities don’t have the population base to warrant their own cardiac clinics, but there are large towns and other cities that could serve these more remote communities.

The fact that it’s such and inconvenience for them to accommodate my husband’s disability is also frustrating. They’re in a hospital, for crying out loud. And with so many hospitals cancelling care to make room for all the pandemic hospitalizations that never materialized, there are plenty of stretchers and beds available that could be used for someone like my husband, without having to prearrange it weeks in advance.

Another unfortunate thing with my husband is that his pain levels have forced him to cancel a number of appointments. He has also done things like walked out after being forced to wait well past his appointment time, due to pain caused by the wait itself, and basically has stood up for himself. He is likely now considered a “problem” patient. I don’t think they realize that, when it comes to his list of health problems, his recently developed heart condition is actually not at the top of the list. Not even close. With everything else going on, this new development doesn’t even phase him, and certainly doesn’t frighten him, as it probably more typical. His pain needs to be gotten under control first. Some of his other health problems are caused by the pain itself, and will improve on their own, accordingly. They have not been able to figure out why his heart failure developed in the first place, and we’re pretty sure it has more to do with the large number of medications he is on, and has been for such a long time, than anything else. We already know that there is no surgery or treatment that can “fix” the physical source of his disability, and it will continue to cause further degradation of his spine. The only real thing that can be done is treat the pain. That’s the foundational thing. Without that being addressed, treating his other problems are little more than stop-gap motions.

This has been explained at heart clinic appointments a few times. I’ve watched notes get taken for his file, that the whole team looks at. There is no reason for them to not be aware of his disability, and what that means for his appointments. Even the fact that we have to drive so far and the affect that has on his pain levels has been duly noted.

Yet when he tries to address this with them, he’s made to feel like he’s inconveniencing them somehow?

Not impressed.

Well, next week he has his first appointment with the pain clinic. Hopefully, that will get the ball rolling on more effective treatment.

The Re-Farmer

Melting

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It was a hot day to be taking my mother for her medical appointment in a van with no air conditioning!

It was already cooling down when I took the above screencap. 28C/82F, with the humidex bringing it to 35C/95F From the weather radar, I don’t expect to get that predicted thunderstorm; it appears to be moving to the north of us. I hope we’ll at least get some rain. It’s been a challenge to keep the garden beds watered. At least I haven’t needed to mow the lawn in a while. :-D

While driving my mother to her appointment, she actually asked me to open the windows more, even though we were at highway speeds. Normally, she’s asking me to close them because of the wind! Well, hopefully we’ll have her car back next week. I could see she was really struggling to get into our van. She’s so tiny! :-D

Her appointment went well. She is frustratingly healthy. All her tests came back excellent. She has obvious issues with arthritis, which there’s really nothing more she can do about, and problems with her knees. She could get surgery to fix those but, considering she won’t even wear her knee brace, there is significant doubt she would keep up with the post surgical requirements, so it didn’t even come up. Her major concern is with her “heart”. By which she means her breathing. But only sometimes, and only in the morning, when she sometimes wakes up gasping for air. The doctor suggested she try sleeping upright, to relieve pressure on her chest from certain generously proportioned parts of her anatomy. I mentioned my siblings and I have discussed getting her a sleep chair, and he said he thought that would help her a lot. He also suggested we try putting something under her mattress to elevate it. I figure we can try that for a few weeks, then assess how it helps or not. She might actually do well with a hospital bed, like my husband’s, which would allow her to lower the whole thing to get in and out easier, too.

He will also be referring her to a geriatric team to assess her. Or an “elder care team”, as he put it. She still didn’t quite understand what he meant, so when we were talking about it later, I explained to her about how some doctors specialized in helping older people, with their physical and mental needs that are different from younger people. Once she understood, she was quite excited about that, saying that yes, she needs that!

Since I was driving her around anyhow, I also helped her get some grocery shopping done, and then we had a very late lunch – in a nice, air conditioned restaurant!

All in all, it went really well, and she was on much better behavior than usual. She was having one of her good days, so it made a huge difference.

After I got home and updated my siblings on how things went, I went to do my evening rounds a bit earlier. The girls had already watered the garden beds. I tried weeding around the beets a bit, but so many of the leaves have been eaten by deer, I don’t know if I should even bother. I’d mentioned this problem to my mother, and she decided that meant we needed a dog. A dog will keep the deer away! I wish I’d remembered to mention that my sister has a dog, and they still had to fence their garden to keep the deer out. And bears, but that’s a problem we, at least, don’t have! :-D

With the bird feeder painted and done, the girls are still doing coats of paint on both sides of the screened window frame for the old basement. Today, I flipped the picnic table and scrubbed the bottoms of the legs clean of dirt, so that we can apply the spray rubber on the ends. I also cleaned a rain barrel I’ve moved near the squash beds, around the cracks it has in one area. I was going to look for some sort of silicon caulking or something to patch the cracks when I realized the spray rubber would actually be better. The application will wait until tomorrow. According to the instructions on the can, the weather we’re predicted to have will affect how well it works. The 14 day forecast predicts continued high temperatures, but no rain, so that will be a good time to start applying layers of this stuff. Meanwhile I want to make some sort of screen cover for this rain barrel, plus the one set up by the house, to keep debris and critters out. I found a bird downed in the one by the house once already – I’m guessing it flew into a sun room window, knocked itself out, then fell into the barrel. :-( Once I have a cover made, and the cracks coated, I will keep the one barrel filled so that we can use ambient temperature water on the squash, instead of cold well water. If we don’t get rain tonight, I’ll likely be filling the rain barrel by the house to warm up, too.

In the long term, I want to get some large tanks like this.

Image source.

They are sometimes available from salvage places for really low prices, and would be ideal for when we plant anything further from the house.

That, however may be a few more years into the future!

Little by little, it’ll get done!

The Re-Farmer

More deer damage, and a medical update

/ Re-Farmer / 7 Comments

We had a really hot day today, so when things cooled down enough, I went out to water the garden plots and sunflowers.

Which is when I found this.

All the leaves on one side of this one have been eaten!

This is the first of the large sunflowers that has had this kind of damage. :-( At least the top didn’t get chomped off.

One of the more recently chomped smaller ones is showing signs of recovery.

It also had a friend!

We’ve got a lot of grasshoppers and locusts this year, but this is the first green one like this that I’ve seen. :-)

When I was done and dragging the hose back to the house, I found Creamsicle napping on top of the straw bale. :-) My coming close for a picture woke him up…

I caught him mid stretch. :-D

Meanwhile…

Today, my husband and I had our doctor appointments that we should have had back in March. They were supposed to be physicals, but the doctor wasn’t expecting that. Which is when I found out he does physicals in the mornings, when, as he put it, his mind it still fresh. Which was not a problem, since we had lots to catch up on. He hasn’t seen my husband since December, and has seen me only while I was accompanying my mother.

Us all having the same doctor is coming in handy.

Before doing a full physical, he wanted us both to get fasting bloodwork done. For my husband’s part of the appointment, we updated the doctor on his upcoming visit with the pain clinic. Even though he hasn’t seen my husband in more than 6 months, he remembered that we’d already been waiting for almost 2 years, so he was a bit shocked that this was going to be a first visit. We also told him about the appointment at the cardiac clinic to discuss my husband getting a defibrillator implanted. He had questions about that. Mostly, why does my husband suddenly have such a low ejection fraction? It turns out that the cardiac clinic has not been sending any files to our doctor, so he had nothing. He still has nothing, really, because the cardiac clinic has not been able to find why my husband’s ejection fraction is so low, and are openly perplexed by him. The doctor has requested for us to remind the clinic to send the files to him, so he can see what’s going on. Same with the pain clinic, when the time comes.

In our previous province, all medical files were electronic, and could be accessed by any authorized doctor. So my husband could go from his GP to the specialists at the pain clinic (all 4 or 5 of them that were assigned to his case), to any other specialist, and they would all have access to the same information. Here, there is no connectivity. When our previous doctor suddenly moved out of province, we had to pay to have our files sent to the new clinic. A GP can access the electronic files at their own clinic, but not the files at the heart clinic or the pain clinic. They all have to send their files to each other, as needed. All of the specialty clinics should be sending everything back to the primary caregiver every time, so that at least that one person has all the information. Why that isn’t happening for my husband, we don’t know, but the doctor was not happy with having so much information missing.

We spent some time talking about my husband’s medications, and the problems he’s been having getting refills for the painkillers. So that’s been updated but, after we get the bloodwork done, he wants to look at switching my husband to morphine, and focus on pain management a lot more. There’s one medication in particular that he was wondering why my husband is on at all, and he just didn’t know anymore. I suspect the total number of prescriptions my husband is on will be reduced.

I’m happy to see him being pro-active about it. The previous doctor didn’t want to change anything until after my husband was seen by the pain clinic, but that took so long, the doctor moved out of province before that could happen!

My own part of the appointment was short. I have only one prescription, and I’ll see him again after my bloodwork is done. We ended up chatting a bit about my mother, since I’ll be bringing her back to see him tomorrow.

As for our follow up appointments, he started to ask if we could book them in the mornings when I mentioned I’d asked for the afternoon, because of the drive. When he realized how far away we live, he completely back tracked and said to make the appointment for whenever works best for us, and to book another “joint” appointment, and he will accommodate us. Since our bloodwork requires fasting, we will book the appointment after we get it done, which likely won’t be until Monday.

So we’ll have at least one more medical appointment this month, on top of the others.

With this doctor wanting to work proactively on managing my husband’s pain, I suspect we’ll be back fairly regularly.

By the time we were done, my husband was at his limit – and we still had the drive home to do. He was worried about his appointment at the cardiac clinic next week. The letter said that there have been a lot of delays, and to expect to be there for as long as 2 hours. That’s after a 1 1/2 hour drive. We’ll have to make sure to call in advance so they can have a stretcher available for him to lie down on; something they were able to arrange to do for him before, after a previous appointment was so late, he ended up walking out because he was in just too much pain. They’re a cardiac clinic. They don’t take into account any other issues a person might have, unrelated to the heart, unless it’s brought up directly.

Another reason why not having central files is a problem. When he goes to any specialist, he has to explain everything else to them. At the cardiac clinic, he could see any one of a team of 5 that works together, so he has to explain his disability, and why he uses a walker, all over again with each one. Otherwise, they assume that his use of a walker is related to his heart condition.

It’s frustrating, to say the least.

At least now we’re able to actually get appointments and treatment. The months of delays because of the pandemic shut downs have really messed things up for him. Our province has once again had more people testing positive for the Wuhan strain of coronavirus, and people are freaking out and demanding things shut down again. What the media isn’t including in their reports (though it’s on the provincial government website, for all to see), those new cases are from 5 days of testing, and represent only .9% testing positive. The total number of positive and presumptive positive cases for the province since March is .03% of the entire population. A person is more likely to get hit by a car than test positive for the Wuhan strain of coronavirus. People don’t seem to understand risk factors at all anymore, and the panic means people like my husband are having a hard time getting medical care. During our appointment, the only time it came up at all was when I mentioned we were supposed to have today’s appointments back in March, when everything got shut down. My husband’s appointment at the cardiac clinic got cancelled. While my husband did get one appointment rescheduled at the cardiac clinic, for a test in nuclear medicine, next week will be the first time the cardiac team will be seeing him. He’s had a couple of telephone appointments, but that’s it. He had also finally gotten contacted by the pain clinic just before the shut down, which that added a few more months to his wait.

If things shut down again, lack of treatment would certainly mean his condition degenerating further. Lack of treatment is more likely to kill him, than any of us coming in contact with the Wuhan strain of coronavirus.

He is certainly not the only person in this position.

Frustrating is really quite an understatement.

The Re-Farmer