Disconnect

It has been slow going for Wife since she's returned from the hospital. The first few days she was totally exhausted most of the time. The last couple of days (a week since the event initiated) she has been showing noticeable improvement. But in the aftermath of the event (don't know what else to call it), She and I have been doing a lot of reflection on the experience with the medical system.

On Thursday, Wife had her first follow-up appointment with her primary care doctor since the event. Let me ask you. How would you react to these words.

• You could have died!
• You had a MASSIVE clot
• They were very close to going into surgery to pull it out

 Here is how Wife and I reacted.

Wide Eyed Fear and a feeling of being totally shaken up emotionally.

And this is after the event. 

This was immediately followed by questions...a LOT of questions and ruminations..

Why didn't we hear any words like this while we were in the hospital system indicating the severity of the problem? There was one person only, the technician who put Wife on the Heparin drip when he told me to stay the night, who verbalized "this is serious. You need to be here."

Virtually all the rest of the communication was kind of matter of fact or incomplete. 

"We're going to do this. And if that is good, we're going to send you home."  

"Why am I on a liquid diet? We don't know. We'll find out. (Much later). They wanted you to be ready if you had to go to surgery." Oh why didn't anyone tell us that? And why was she going to need surgery?

The hospital doctors saying, "We're sending you home. Take it easy for a week. Then you should be able to start doing your normal things." Versus the primary care doctor, "You just had a major trauma to your body. You need to take it easy. This is going to take a while to recover."

As we reflect upon the experience, we recognize on one hand that many parts of the system didn't seem to know what our situation was. Maybe they are so overwhelmed that they can't know what is going on with each patient. But on another level, there was clearly some kind of communication and discussion going on between the hospital doctor, the vascular surgeon, and maybe others where they were making decisions on the pathway of Wife's care. It seems as if our primary care doctor was aware of this. How come we weren't brought into the loop? Are the patient and their loved ones just extras in this drama?

So in addition to the emotion we've been feeling, there has been a lot of talk about what do we do when the next even takes place. Because at our age another even IS going to take place.

Wife Goes Through The Looking Glass (Part Three) - A de-I Family Health Adventure

It is Saturday. I make my way back to the hospital. Things are pretty much status quo. Wife said she actually got some reasonable sleep. She's eating her salt free fried eggs without much gusto. I joke that I should have sneaked in some salt. But she's adamant. Whatever it takes to get out of the hospital she will do. 

I am figuring out that the hospital staff is actually pretty happy if you, the patient's relative, will do a lot of the mundane tasks. Unplug the monitoring device so it is on battery and she can go to the toilet or take a walk? Sure. You do it. Go get tea, coffee, crackers, etc from their 'nutrition' room. Sure. Be the one to walk her around. Sure.

So I get Wife some tea and I get some coffee. Her room mate is off for dialysis so we are alone in the room. It is a waiting game. I made myself a sandwich so I could eat when she got her meal. Compared to Friday morning when there was so much activity, there is a lack of interaction with the hospital staff at all in the morning. 

Around midday, we see both doctors (not at the same time). Both confirm that Wife is responding well to the anticoagulant. The vascular surgeon says Wife's vital signs are pretty amazing considering what she has gone through . (Go Wife and her regime to take care of herself!). They say they are ready to release her and put her on an oral anticoagulant. All they need is one more blood test to confirm the drugs are working as they should.

Now again we descend into the hospital waiting game. When are the blood people going to come? We kill time by my researching the two likely drugs she will be given, their side effects, and costs. The side effect information is promising. Not many all things considered. The price information? Not so good. This shit is expensive. Fortunately the doctors have told Wife she should only be on them for three to six months.

It is late afternoon. Will these blood people ever come? And if they come really late, will they be letting Wife discharge? And if the discharge time gets past 9pm, is that the best thing for Wife and I? Wife and I go for another of her walks around the floor. It makes a nice loop. We are doing three loops. Wife is getting very good at driving her pole around the various obstacles we encounter.

Wait!

We are coming to a room where it looks like the 'blood sample people' are outside doing their thing. We talk to them. Yes, they are in fact the 'blood sample people' (makes them sound like they are some kind of dark aliens). And they confirm, Wife is on the list. Great. They are on the floor and not all that far from her room. We finish our laps and head back to the room feeling upbeat that this last hurdle will be jumped.

Accept they don't come. Hours go by. It is around 5pm. Wife and I debate. If I stay, I am getting more anxious. And knowing Murphy's Law they will not come. BUT, if I go, they are sure to come and I will have to turn right around and come back. We make the decision for me to go home. I am grabbing something to eat. I won't drink any wine because I might have to run back to the hospital. Sure enough. Within 30 minutes of my leaving the 'blood sample people' show up. Not terribly long after that, the results are given to the doctors and they give the green light to discharge Wife. She tells me to come on and pick her up. She's feeling pretty upbeat.

But there is one last delay (in my hospital experience, this is almost a given). There is no one around who can actually produce (print out) the discharge instructions and give them to Wife. So I have to go back up to her room and we wait another 30 minutes until finally a person arrives, gives us our instructions, and Wife is officially released and wheeled down so I can take her home. 

We get home. She's beat but happy to be in her own house and bed. After she crashes, I have a drink and give a multitude of thanks that we've managed to dodge a real bullet. From the time Wife had her appointment with her primary care physician on Thursday to getting her home has been roughly 56 hours. It seems a lot longer. A business network friend of mine told me today at lunch his wife has a serious form of cancer. I know things could be a lot worse. I am grateful we've been able to get through this as easily (relatively speaking) as we have,

Wife Goes Through The Looking Glass (Part Two) - A de-I Family Health Adventure

 Wife is now fully assimilated in the Other Dimension of Reality that is the Hospital System. It is a world where communication is almost always incomplete and random. It is a world where long periods of inactivity are interrupted by a constant flow of activity. This is a world where facilitating that most important of healing activities - rest - is constantly assaulted by light, sound, and activity. Let's follow Wife's journey through the Hospital Dimension.

I get to the hospital at around 8:30am on Friday. Wife is a bit spacey. She's not had anything to eat. I brought here a cheese sandwich as I had a feeling that her nutritional needs would be lost in the shuffle. She's now been in the hospital for a couple of hours. Nothing has happened. 

At about 9am, the floodgates open. In come people to draw blood. At the ER, they had put in two ports in her arm telling her one was for the anticoagulant drip to go in and the other was for taking blood out for on going testing. However, they tell her they must poke her again in a separate place to draw blood. She tries to explain about the second port but no, the blood people are adamant. They MUST make a new poke. They will do this for the entire stay. (We will finally be told by her hospital doctor almost as she is leaving when we asked why, that it the extra port is to allow easy access to put things in her if a crisis should have occurred. Nice to learn this just before we leave!) There are all kinds of other comings and goings. 

They come in to do an ultrasound of her heart. This takes 30 minutes. The med tech tells us she can't interpret the results. HOWEVER, if she suddenly calls into her intercom for a doctor, that will the signal that something bad is happening. Great. the 30 minutes comes and goes. No call for the doctors.

With all this complete, we are left with a final message that the doctor will be coming and let us know what is going on.

It is a little before 10am. There is this kind of sigh of relief as the intensity of of activity has subsided. Wife tries to get some sleep. We're waiting for the doctor. We will wait a long time. He and his colleague from vascular surgery won't show up until around 4pm. 

We are waiting and waiting, wondering and wondering. We know this is no small matter. But we have not a clue as to what to expect. What kind of treatment will be recommended? What is her prognosis? And she still hasn't been fed! We were able to build a good relationship with her nurse, Anna Kai. She found that Wife had been put on a liquids only diet. Why? Anna didn't know. Those were just the instructions. And it turns out you have to order your food. So Wife finally gets a rather insipid meal of broth, a sugarless popsicle, and juice. 

Wife and I kill time by figuring out how to unplug her monitoring device so it runs on battery and she can get up by herself and go to the toilet. She has lucked out big time in the room. These are converted former one patient suites. They now hold two people because the hospital is desperate for space (lots of old sick people these days...I'm looking at YOU de-I...OLD). There are no proper curtains separating the spaces, just some flimsy portable screens that are in danger of falling over at any moment. The front 'room' has virtually nothing in it. But the back room by the window is grand with a big couch and a separate chair for Wife to get up out of the bed (which is killing her back). I make use of the couch to lie down frequently. Even though I'm hardly going through the trauma of Wife, I'm feeling pretty beat.

Finally, at about 4pm a doctor shows up. This is our 'hospitalist' or our hospital based caregiver. He is of South Asian descent. He is type A+++. It is exhausting to go through a session with him. BUT he cares. You can tell. And he gives you information. He answers all your questions. Shortly after him, we meet the representative of Vascular Surgery. She is equally energetic, though in a bubbly, friendly kind of way. You are not exhausted after being with her. 

We FINALLY now understand the majority of the picture. The short of it was they needed to see if the anticoagulant was working. If it wasn't, they would need to do some kind of surgery to remove the clot. Hence the liquid diet. But no, Wife was responding well. In fact they were lauding all her vital signs (Go Wife and your long efforts to keep exercising and eat right!). So no surgery. And they could move her to a solid diet, the 'heart friendly' (aka tasteless, bland) diet.

Now we finally have the picture. If Wife's blood work (which evidently provides markers that the anticoagulants are working and dissolving the clot) keeps going in the right direction, they could let her out on Saturday.

We decide it doesn't make sense for me to stay any longer. At 5:30pm, I head home. I do a bunch of laundry so Wife can have clean sheets and towels when she gets back. I eat some leftovers. I text Wife to make sure all is still calm at the hospital. Fairly early, I conk out. Hopefully, tomorrow, Saturday, she will be released.

Wife Goes Through The Looking Glass (Part One) - A de-I Family Health Adventure

Wife and I are back at the Tower after a 56 hour whirlwind experience in that alternative reality known as the U.S. hospital system. Shortly after our return to the United States from Europe Fall 2024, Wife noticed she was having extreme fatigue. Then she started having pain in her left arm. And it began to swell. Thursday morning she noticed odd black and blue marks on her arm. She already had an appointment to see our doctor. I was off for some client meetings. At 3pm just as one of the client meetings was starting, my phone rings. It is Wife. 

Wife NEVER calls me during business meetings. She would leave a text if there was something she needed so I would contact her after the meeting. This was not normal. I answered. She was short and to the point.

"de-I, I have a blood clot. Doctor says you need to come home ASAP and take me to the Emergency Room."

Right. I made my apologies to my client and headed home. Once there, I got Wife and off we went to the Urgent Care/Emergency Room facility indicated by Doctor. As we were driving, I knew we were about to Go Through the Looking Glass again. For those who might not have been following me back in 2008, I wrote quite a long, long post about my experiences with the hospital system from my kidney donation. So I had a pretty good idea of what we were in for. I will say it wasn't quite as bad as that one. Presbyterian Hospital and Healthcare System in Albuquerque is a far better organization than Hartford Hospital in Hartford Connecticut was back in 2008.

(I am sure once Wife gets her energy back will write her own post about the experience.)

Let's go Through the Looking Glass

The Urgent Care/Emergency Room facility is a huge standalone not part of a hospital. Despite its size, it has a tiny waiting room. I was actually familiar with the facility as I had been there in March of last year. So I had some idea of what to expect. 

Enter the facility. Go to registration. In our case, our doctor had already sent in the preliminary diagnosis with the tests being requested.

Look around the tiny waiting room with coughing people and the screaming child.

Find the only place to sit which faces the large windows that have the setting sun glaring right in your face.

Watch one of the people at the reception desk go lower shades so 'She' doesn't have the sun in her eyes. The patients? Not her problem.

After a long wait, Wife is called in for 'Triage' to get a handle on what the issue is. Back into the waiting room with the coughing and screaming child.

Another long wait.

Wife is called in for two of the three tests she needs. 

Back into the waiting room with the coughing people and screaming child.

Another long wait.

Wife is called back for the last of the tests, a CT scan. They tell her she should now be given a room in the facility but the rooms are all full. So go back to the waiting room with the coughing people and the screaming child.

We are two hours into our visit. 

Finally, Wife is given a room. We are really lucky. During our night at the facility, we will see many people who are in their hospital beds in the hallway. 

About three hours into our stay, a doctor comes in and tells Wife her clot goes all the way from her elbow through her chest and is approaching her heart.

!!!!!!!!!!!!!!!!!! 😳

We are both in full on fear mode.

We are told she will be put on an anticoagulant medicine that is delivered by drip. This means she will need to be in the hospital for a few days until they are convinced the clot is under control and starting to dissolve. They will transfer Wife to the main hospital via an ambulance as they have to maintain the drip going. 

One problem. There are no beds available at the hospital. We will have to wait in the UC/ER facility until a room is available. The technician who has been hooking Wife up to her drip, tells me in no uncertain terms, I need to stay with Wife until they get her to the hospital because, "Who knows what will happen! You need to be available." I am not looking forward to spending the night in the ice cold meat locker in a small, hard chair. 

Fortunately for me they have these recliner type chairs for just such a situation. They bring one in, It almost goes completely flat. It's like a poor quality business class airline seat. As I'm used to those, I manage to get some sleep, Wife, of course, is going through much worse. They are continuing to poke and draw blood, doing EKG's meaning she's got those patches all over her chest. 

So we honker down for the night. I actually get some sleep. But I'm up at around 4:30am. I am thinking, "My experience was hospital discharges are usually done in the morning after the attending physicians see their patients and give the okay. So it might be late morning or midday before they move Wife. I'm still wearing my business clothes. I go to the nurse attending us and ask if it would be okay for me to go home and get a shower and return as it most likely will be many hours before Wife can get a room. She tells me they now do admissions and discharges on a continuous basis. Wife could get a room at any time. But she doesn't know why I've even waited all night. Her attitude is completely different from the guy you set Wife up on the drip. 

We decide I should go home, shower and get something to eat. I do this as quickly as possible. Before I leave, I check with the facility. She is now at the hospital. I pack up some things like my computer, chargers, Kindle, and head to the hospital

End Part One

Acceptance On The Home Front

In my end of trip, 'navel gazing' post, I wrote about the power of Acceptance as a critical component of the trip's success. I also alluded to bringing that attitude to our life here in Albuquerque. 

Regular readers know Wife and I have struggled mightily with our life at home. Do we keep the house? Do we move? Where? What do we want? If we can't get what we want, what do we do? And more of the like. This has led to a round of frustration for almost two years. The circular logic went like this...

• We didn't want to take care of the big house and yard any longer
• We wanted the high-rise, apartment, live in city where you could walk everywhere lifestyle (see our loving of El Campello)
• But I need to keep working some to pay for our travel
• If I need to keep working, we have to stay in Albuquerque because that is where my network and reputation are. Not going to go somewhere else at this late date and put in all the work to build a new network and reputation).
• Can we find the high-rise, walking lifestyle in Albuquerque? No!
• So we have to stay in the house

Hence we set out to get the house fixed up so we can stay here long-term. But that became its own 'Groundhog's Day' of trying to achieve a perfect outcome.

Coming back from our trip, with our new acceptance attitude, we have focused on 'What is reasonable and can actually get done'. With that mind shift, suddenly an number of logjams have broken. We are hoping in a few weeks to have some commitments for getting the work scheduled and done. 

In the meantime, I have been immersed at getting my business practice up to an acceptable level. It hasn't been that hard. I know what I'm doing. I know how to connect people. I do good work. And the fact that my women in Ghana have stepped up and been able to take responsibility for the day-to-day of their business means I don't need to be up at early hours doing that work so I have better work/life balance.

How's this for the 'Acceptance' contemplation?

I get to travel the world in style. I spend months enjoying the pleasures of other cultures and leading a completely different lifestyle than I did in my 'work-a-day' career days. I live in a lovely house that many would die to have. I get to use my experience and mind to help others to achieve their personal dreams AND I get paid to do it. I have been given the opportunity to change the trajectory of women's lives in a part of the world where hope is a scarce commodity. And that has given me yet another experience of another completely different culture. And I am doing all this at an age when the vast majority of my peers are checking out on life.

I think I can ACCEPT this.

Cooking

As usual, upon coming home, it is hard to get back into the blog posting routine. Often times this is because I have a hard time coming up with topics to write about given the intense posting done while traveling. But it also, I am often tired at the end of the day from working and don't have the energy to write something. However, this time I have quite a bit of things to write about so I need to find a way to build it into my schedule. 

This weekend I had the urge to cook. Wife had requested chili con carne. I wanted chicken fricassee. And I wanted to make two condiments (green chile sauce and harissa) that I much prefer making myself.

 Chicken Fricassee

This is a long-time staple of my family. It's one of those foundational dishes that one associates with one's culture and family. I actually made this with 2.2 in Valencia and told her she was now officially in the lineage of Jewish Mothers and Grandmothers who have made this from time uncounted. It's incredibly simple to make.(I'm sure in some post in the past I've shown this before.) I like the Hungarian version which adds a ton of paprika to it.

 Step One - Get a chicken. Cut it up (You could buy pieces. But be sure they have the bones and skin which are important for providing flavor

Onions and Garlic - Lots

Throw those in with the chicken and add a healthy amount of salt, black pepper and paprika, preferably Hungarian (like those precise measurements - 'a healthy amount' ? That's grandparent cooking technique...designed to drive younger generations crazy!)

You then work the onions, garlic, and flavorings into the chicken by hand. The technical term for this is 'smushing it together'.

 Fully Smushed

Add about a cup to two cups of water, just enough so it is maybe a half inch above the bottom of the pan. Bring to a boil. Lower the heat and cover. Cook for about two hours until the chicken is tender. You will be amazed by the amount of liquid that the onions and chicken generate.

 

Also made were the Chili con Carne

And the Green Chile Sauce

 However our experiment with making Harissa from chile powder was less successful

 It came out too grainy and the chile flavor overpowered the other flavorings. And despite a lot of additional fluid added, it was too thick.

I tried to 'fix' it today but was not terribly pleased with the results. Sadly I have a ton of it so it will be a while before I try again with chile pods.

Europe Fall 2024 - Finale, Great Navel Gazing Post

We are back home after a relatively uneventful trip back home. Actually with the exception of the chaos of our getting out of Alicante to Amsterdam, the rest of the trip was smooth. We were even able to get our bags in Albuquerque and secure an Uber home in record time. Both Wife and I have done a good job at managing the jet lag and have been very productive despite having only been home for a couple of days. The transition from the travel life state to the home base state has been relatively smooth. I will discuss that in the next post. But, as I have done ever since we started our significant travel life a decade ago, I will conclude with my analysis of our experience or as #3 has called it the 'deep navel gazing'. 

Accept and Enjoy

The backdrop of this trip was Wife and my desire to transition from travel oriented on going to many places to a more single location oriented model in line with our decreasing capabilities as we age. However, finding the 'place', that locale where one would be happy going back again and again had proven to be a mighty challenge. 

Thus a major goal of the first part of our trip was trying to find this elusive 'El Dorado', the place that would have all the features we wanted. As you know, that turned into an exercise of extreme frustration. We even carried this attitude of looking for the 'perfect place' into Spain when we first arrived in El Campello and started to visit the other coast side towns of the Alicante area along with the accompanying frustration.

It was at this point that Wife had a powerful realization. Something she had read talked about the importance of accepting, meaning accepting where you are at and taking joy in that as it is. She said she was ready to make that leap. And if she was, I sure was too.

From that point, we just immersed ourselves into our lifestyle in Campello. I wrote four posts on the specifics of why this small city resonated with us and why the specific apartment we were in was such a big part of it.

The Transition Bullet Train Keeps Chugging On!

In July, I wrote about the growing realization that my 'transitioned lifestyle' was not an even but an on-going process with (it seems) no end in sight. I took this to heart for this trip. 

First, had to do with letting go of managing Theodora day-to-day. My Board members (aka #2 & #3) had beat me up with this at our annual meeting in July. When I was in Ghana in August, I worked with the team to let them know they would have to take responsibility for their day-to-day work. And with my departure to Italy in September, I did just that. And, low and behold, the team stepped up and have taken care of just about all of the regular execution of their business. I will write a separate post about this as it is actually a fairly major accomplishment.

Second was now filling in the time that we'd created by not running around all the time, and, for me, the time I was using to manage Theodora. We did this by renewing projects we'd both put on hold. Wife threw herself into her photography. She essentially created her own 'course' by going to multiple online resources. I found my 'new' passion going back to an old one, the writing of my 'Story'. This had been essentially been on hold/stuck (depending on your point of view) the whole time I'd been creating Theodora from scratch. Suddenly, I found breakthroughs in the story line. There followed an out flow of ideas that have led to an outlining of the end of the current book in the series, along with the first parts of a next book. I will write more about this in a future post.

Pluses and Minuses on the Physical Capabilities Front 

One of the most amazing things of this trip was a rebound of sorts by both Wife and I in our physical capability. Please! Don't get me wrong. We are not suddenly back in our early 50's. But over the course of our trip, particularly while we were in Campello, we found ourselves doing more and more walking, and particularly climbing. Issues we've both had for quite some time, seemed to mellow out.

Be assured, we felt it. I think there is another whole post I can write on dealing with pain as you age. But the point is we were doing things we couldn't do just last year. We still had to be very circumspect and not do too much, stop when we recognized the signs that we were going over the limit. 

But it was a joyous realization. It made us much more upbeat about what we will be able to do going forward. 

Now the negative. It is so clear that there is only so much stress I can handle. And if you combine stress with significant load bearing physical effort (i.e. moving luggage around), I am going to go into an exhaustion mode pretty quickly. This was fully brought to light during the Italy part of trip with our having to find and move into many different lodgings. I would find myself completely drained and barely capable of doing anything. Scary. Fortunately, it would only take 2 to 3 hours of rest for me to bounce back. Nonetheless, this yet another motivator to make the transition to staying at one place for longer periods of time.

The Miracle of Our Being European Drivers 

A key to our ability to do as much as we have done traveling in Europe during the decade of the transitioned state has been our ability to drive. I discussed this right after we arrived in Italy. As we continued our trip, especially during our time in Spain, I continued to be amazed at how much we've learned and incorporated. I am very proud to say during this trip we managed to not have ourselves inserted into narrow, dead end mountain village roads. We only went the wrong way in parking garages when there was little to no traffic. And for the most part, our guests seemed to not have their hair turn white while they were driving with us. I know this is a bit egotistical ("but hey, you're de-I? Isn't egotistical a synonym for you?") but I take a lot of pride in Wife and I (for we are a total team in this) in our late 70's being able navigate and get around in Europe.

Sharing the Experience 

One of the joys of our stay in Spain was our ability to share what we were enjoying with others. We had our niece, RMG, visit us. We went to see our granddaughter, 2.2, in Valencia twice. We had the VEFS mercenaries 3.1 and 3.2 visit us from Sweden. Seriously. This was such a joy. 

How Good Was This Transition? We're Going Back 

Yes, even before we had completed our trip, Wife and I talked and decided we wanted to come back to Campello, to this same apartment in 2025. And we have so committed. We booked the apartment again for October 2025. All our guests from this year have already expressed interest a desire to repeat. This is so exciting.

Conclusion

So there you have it. Two months of European travel with a lot of beauty and enjoyment. Some great personal growth and I believe the laying of a foundation for the next stage in our personal travel adventures.

Age: The Final Frontier. These are the voyages of de-I Sandia Outfitters' Eldership. Its mission to keep going and not stop. To go boldly go where few elderly have gone before.