Friday, June 30, 2017

In Response to a Request from Cate Poe

Photo by Cate Poe.  I used it because I am obsessed by doorways & thresholds & the possibility of transgression or transformation or discovery or a path to a pocket of resistance…

My friend Cate Poe, fierce woman, intrepid traveler, passionate organizer even in retirement & fellow writer, wrote the following in response to an article in the New York Times, “How We Became Bitter Political Enemies,” by Emily Badger & Niraj Chokshi:

Things got really polarized this past year, but at least within the broadly labeled Democratic Party camp, I'm noticing a lessening of hostilities and a recognition that on most of what faces us in the months ahead, there is plenty to do together.  What's your recent experience?

Cate, in her usual concise & well-crafted fashion, told of her experience with Democrats Abroad in her home base of San Miguel Allende in Mexico: 

On the ground, some of my closest collaborators are proud Pantsuit Nationists now willing to make room for even a die-hard Sanders supporter like me.

Through Cate's posts, I have followed the resistance movement in San Miguel Allende via Cate's posts – the house parties where diverse collections of women with shared concerns & goals gather & make phone calls & write post cards to their home states’ representatives in Congress.  Sometimes they target key potential swing elections. 

Their connections across time & space are incredible.

It is amazing & inspiring to watch these ex-pats who are still engaged with their home country * who still vote.

My own resistance & activism takes place between my role as my mother’s primary caregiver & advocate & neglecting dirty dishes in the sink & laundry that needs to be folded & placed in its proper place.  Not to mention pulling weeds & tending to a much neglected yard.

But I make calls.  I write emails & mail post cards.  I encourage friends in other forums to do the same & share sites to aid them.

Over the past days, I have given a great deal of careful thought & reflection to Cate’s call to share my experience of a lessening of hostilities

Because my role as my mother’s caregiver limits the parameters of my physical world, I interact outside of Facebook only with a few fellow Democrats.  My Democrat friends, some through FB, others who were a major part of my past lives, are a diverse group.  I would love to gather them all in a room together, childhood friends, friends of childhood friends, relatives, Facebook friends introduced to me by friends of those past lives.

I would invite other friends to that gathering – thoughtful, introspective, insightful friends who do not tend to lean to the left.

Never doubting that the dialogue would be scintillating.

Unlike Cate, I am neither concise nor carefully crafted.  I am verbose & totally incapable of limiting myself to an assigned page limit.

Which is why I am not a poet.

I live in a one square mile city in one of the most strongly Republican counties in the country.  It is like living in a bizarre, toxic version of Mayberry, RFD.  There are small pockets of resistance, other rare Blues.

For years, I have had a friend in the community who does NOT lean anywhere left or Blue.  I met her when my eldest son & her sons were in Cub Scouts.
Over the years, with my entry into Facebook & the advent of Obama’s second campaign, I came to realize that my friend who does not lean anywhere left or Blue forgot what she assured me when she first friended me on Facebook:

Friendship transcends politics.

Eventually, even after continued requests to agree to disagree, I had to block this never left or Blue friend from my news feed earlier this year.  I felt strongly on the issue we debated at the time (it was not about our current leadership, but was about a link she sent me from a “fabulous” radical feminist group). 

She felt equally strong, but it was apparent that she was coming to the issue from a place & philosophy I could not fathom.

A dark space I refused to visit.

So, I made a difficult choice.  I found it necessary to stop listening to or participating in a dialogue designed to save me from falling into the liberal abyss.

Cate wrote:

And, yes, there are a handful of friendships that I doubt will ever recover. That doesn't make us bitter enemies, as per this headline, we've just moved on after regrettable interactions.

My choice was several months ago.  More recently, on the morning of the tragedy at a baseball field in Virginia someone forwarded me this from my dear, blocked, friend:

This tragedy is a direct result of liberal propaganda, hate speech, prodding by democrats and resistance groups.  I hope every one of the people who participates and propagates this type of communication takes full responsibility.  Thank you to Capitol Police!

No longer reacting immediately, wanting to slay the conservative dragons accusing liberals of using the same hateful rhetoric our current POTUS has espoused & continues to espouse at every opportunity since he descended the escalator in Trump Tower, I laughed.

Of course, it is not funny.  

As a liberal & a Democrat & a woman who resists, I was incensed & outraged.  But to respond to the post would have given it a power it does not deserve.

Laughter was a different kind of release. 

No response I could have written would have diffused it or moved its writer.  

This is our reality.  Some dialogues & discussions cannot take place & remain civil.

The battle ahead is not how to convince the immovable opponents on the Other side of the aisle, but to unite Democrats & Independents in a coalition to regain some semblance of control over & restoration of our republic & democratic process.

And over the last months as I have struggled with how to respond to frustrating & inflammatory posts, I have been reminded by something my mother Jean told me when I was attempting to raise my sons:

Save your big guns for your big battles.

Caring for Jean reminds me on a daily basis of how important those big guns are, how life altering those big battles can be if we have wasted our energy on skirmishes we cannot win, on opinions we cannot sway.

So with Jean’s help, these past months have taught me to listen more, to attempt to refrain from speaking without truly thinking, to contemplate the projected outcome of my discourse.  

It is not acquiescence on my part.  I wish it was resulting in a kinder & gentler Jaki Jean.  But I am still a bitch at heart, I still do not suffer a fool gladly, I still have a temper that reacts all too quickly.

I still want to instinctively reply Are you fucking kidding me?

Not acquiescence, but choosing a battle that can make a difference.  About formulating a plan & taking action.

While I have not yet shared Cate's positive experience, I share her optimistic interpretation of a lessening of hostilities within the Democratic party.  And I recognize pockets of resistance to the toxicity that has unfortunately become our norm.

Something I learned a long day ago, in reading & writing about literature.

There are always pockets of resistance.  In every walk of life.  

Thursday, June 8, 2017

On 72 Hours (& beyond) in My Life as a Caregiver

When I told my friend Muriel that I was going to write a blog entry about 72 hours as my mother Jean’s caregiver, she replied with a laugh: 

I think your role has lasted more than 72 hours.

Muriel was right – it has been a much longer journey than three days.  

But two weeks ago, three days & events were extremely challenging, perplexing, & frustrating.  Not because of Jean, but because of just one of things that threatens recipients of home health care.

On Tuesday, May 16th, the home health care agency we have used for several years, informed me that Medicare had denied coverage of services for Jean, that they had no choice but to cease providing those services & had not been reimbursed by Medicare for the past year.

Because I trusted these nurses with my mother’s well-being & they had come highly recommended by a nurse who cared for my mother at the Advanced Wound Care Clinic at Methodist Hospital Sugar Land, I believed them & was devastated.

Last year, this same agency told me that Jean’s PCP would not sign off on home health care services, postulating that perhaps her doctor of several decades had committed an infraction of Medicare regulations & was wary.

I changed Jean’s PCP & got new orders for home health care

During these exasperating & confusing 72 hours & beyond, I contacted a medical supply provider to inquire about Jean’s ostomy supplies.  I wrote Senator John Cornyn, asking for his office’s assistance with appealing to Medicare.  More on that later.
I also called Medicare.

After a lengthy two hour phone call, which involved my proving that I was authorized to speak on Jean’s behalf, I learned some amazing truths & reassurance.

Medicare informed me that Jean does indeed qualify for home health care services.  They also gave me dates & amounts paid to the agency we were using. 

This agency did not terminate services (they are required by regulations to notify us in writing & so far, we have received no such discharge notice) because of non-payment & denied coverage.

These nurses to whom I entrusted my mother’s care terminated services because they were not willing to accept payment within Medicare’s parameters.

And they mislead me & lied to me.  Or perhaps they offered alternative facts.
And underestimated me.

Did they not think I would make calls?

During those disturbing 72 hours & beyond, I contacted Jean’s current PCP & spoke with the staff member who coordinates all home health care services for the doctor’s patients.  Jean’s doctor has a preferred provider & the nurse assured me that they have never had a complaint about the agency he prefers.

In the process of trying how to obtain Jean’s ostomy supplies, the company I have been dealing with told me that Jean’s supplemental insurance said her account was no longer active. 

I called my sister Janet & said I have a crazy question to ask you because I did not believe that she had changed Jean’s supplemental insurance without telling me & giving me Jean’s new insurance card.

I also could not believe that all of Jean’s physicians have been sending claims & not calling about a lapse in coverage.

Jean’s supplemental, United Health Care through AARP, informed me that her account was absolutely current.  On a whim, I asked if our home health care agency had sent in a claim for a portion of what Medicare did not cover during 2016 or 2017.

The answer was a resounding no.

So, perhaps the agency we will never use again has a poor business model. 

I have no doubt that there is money to be made in home health care services.  But a provider needs a full staff & patients.  It is not always possible for the principals to be the nurses who visit patients to have a full-time job at a hospital.

Now, before all the nurses & home health care nurses I know respond in anger, my opinion of & respect for nurses remains intact.  I trust nurses & nurse practitioners.

However, I do not like being lied to or mislead about my mother’s eligibility for home health services. 

If I had been told the true reason for the agency, that my mother’s situation & care was not profitable, I would have been pissed.  I would have had the benefit of honesty.

Now, I am not just pissed.  I am enraged.  Not just hurt or disappointed, but full throttle enraged.

I contacted the Ombudsman for the Texas Department on Aging. 

The, beyond the 72 hours, I received a text from the agency we have been using.  I will be there around noon & we will talk.  We will keep her.

Minutes before, the nurse at Jean’s PCP’s office called to update me on the status of engaging their preferred agency.  I told them to continue the process, that I was no longer comfortable with caregivers who offered me alternative facts.

Then I texted the agency that gave me those alternative facts.  No need.  I spoke with Medicare & Jean’s supplemental insurance & Dr. Lalani’s office.  We will be using a new agency.

In my continuous effort to remain Jean’s fierce advocate while striving to be a kinder & gentler Jaki Jean, I did not remind the caller what she should have known.

When it comes to my mother’s care, I do not play.

Last week, the recommended agency arrived.  I went over exactly what brand & type of ostomy bag was required.  I gave them the company name, the order number.  I explained all the reasons this particular style of bag worked with Jean’s stoma, its position, her bowl movements, her sensitive skin.

A few days later, two boxes of supplies arrived: catheters & bags, gloves, gauze, bandages, saline solution, skin protectorant, wound retention tape.  All of which we have. 

And a box of ten of the poorest excuse for a replacement for a Coloplast Sensura one piece, self-closing ostomy bags with a wide adjustable opening. 

All my attempts at a kinder & gentler Jaki Jean went out the window.  I made phone calls.  A lot of phone calls.

Patience is not my stronghold.  I waited overnight for a response & an offer of a solution. 

A physical therapist booked a session for yesterday.  Unfortunately, a nurse by the name of Crystal called to ask if she could come & see Jean.

I explained that Jean was booked, that two visits from strangers in one afternoon was too much for her.  Crystal pushed back, insisting that, because Jean was being treated for a wound, it was essential that the treatment be on a regular schedule – on the same day of the week.

Frustrated, I unleashed on her.  I apologized, telling her that I knew it was wrong for me to inflict my frustration on her. 

I agreed to let her come.

She did & I remained in the room to watch exactly how she would handle caring for Jean.  Crystal was excellent & extraordinarily patient with me.  Or at lease pleasantly tolerant of me.

As I signed her notebook, a kinder & gentler Jaki Jean emerged.  I asked if she was old enough to remember before we all depended on our devices, if she remembered nursing without a notebook in her nurse’s bag.

She smiled & continued the conversation until somehow, we were talking about the fact that we both have sons who were obsessed with Teenage Ninja Turtles. 

I thought by finding some common ground, some shared experience, I could make her understand that all though I genuinely want to be a kinder & gentler Jaki Jean, I am a bitch at heart.

When she left, she was more relaxed, her tone very different.  She was laughing (after all, I did get voted “Most Witty” my Senior year in high school).

After Crystal left, our new agency called, telling me that the Regional Director was working on a solution & it would be offered soon if I would just be patient.

Patience is not one of my strengths.

Yesterday, after Charvey (I keep wanting to call him Charlie, but it is Charvey & I have to remember a six-foot rabbit with a C) the physical therapist left, the doorbell rang & UPS delivered a package.

It was a box of twenty Coloplast one piece, self-closing ostomy bags with a wide adjustable opening.  Including disposal bags.

I won the understanding of a fine nurse on Tuesday afternoon by resurrecting a kinder, gentler version of Jaki Jean.  I won it by opening up a dialogue.

Yesterday,  I won a battle with a major home health care corporation.

Not by resurrecting a part of myself I have to constantly bring to the surface, but by being a relentless advocate to assure Jean has the best care available.

I won the battle by being a bitch.

And I was reminded:

Sometimes you have to be a high riding bitch to survive, sometimes, being a bitch is all a woman has to hang on to. 

 . . . Dolores Claiborne

Tuesday, June 6, 2017

In Defense of Kale

One thing I have learned on Facebook during these bizarre & disturbing times is that I may be the only person among the people I accept as friends who truly enjoys consuming kale.

For some time now, the same meme appears in my Newsfeed – from family members, friends of family members, friends, children of friends.

About kale:

Several things about these posts disturb me outside the fact that I love kale.

I also love coconut oil.

Although I usually use it on my face & body – unrefined organic coconut oil.

I object to any attempt to cook greens of any kind in a skillet.

The youngest of nine children, my mother Jean grew up on a farm in East Texas. 

There were cows for milk, pigs for pork, chickens for eggs & eventually used for meat & whatever my uncles shot. 

There was also a garden.  Which included greens.

My childhood included meals cooked by my mother that did not include meat.  Beans, greens, beets, sliced sweet potatoes.  And cornbread.

The greens were mostly cabbage, mustard & turnip greens.  But I loved them.

It took me a long time to discover kale.  After years of trying to find to find the perfect way to cook greens & use them.

I finally found it in a Mario Batali recipe for acorn squash.

Cooking the greens involves red pepper chili pepper flakes & olive oil & a bit of tomato sauce until the greens get tender.

The acorn squash recipe, which called for a topping of greens, was a hit at a Thanksgiving dinner
Platters of greens using the recipe was a bigger hit in a subsequent Thanksgiving dinner.  When my brother-in-law declared them the best greens he had ever tasted.

Greens rock.

When done right.

I can make a kale so tender & unrecognizable from its original form, all doubters will grab a slice of cornbread & indulge.

Now, in defense of the recurring meme on my newsfeed advocating for the use of coconut oil to make it easier to dump kale out of the pan into the trash – I do not like raw kale.

Except in green smoothies.  Kale is nutrient rich & in my green smoothies, mixed in with moderation along with spinach & a bit of pineapple & banana & Greek yogurt high in protein & whatever other fruits need to be used – makes a damned tasty smoothie to start the day.

So, in defiance of my Facebook friends, I stand by kale.