discharge planning – Jesus is for the Wounded

Who was it who said to “start with the end in mind?”

Well the “end” of everything in life as we know it will not be death per se but the second coming of our Lord, Jesus Christ. He will be bringing about the Great Tribulation, reign on Earth for 1,000 years, bring about the death of Satan and the world as we know it, and bring those who believe in Him to the New Jerusalem. There we will reign forever with the One True God. I can’t wait!

And yet wait we must as it is not the time for His return. So working back from this end I will examine a few personal challenges the current day . . .

Brother Mike

Incredibly with a remaining part of one of two carotid arteries, my brother is making slow progress (after a massive stroke two weeks ago). As it turns out his progress may still not be enough to keep him longer in a rehabilitation facility. Enter here the plight of the uninsured. Decisions about his care will be made by a team of therapists who are required on Wednesday to make an “educated guess” as to his the outcome of his treatment 2-3 weeks from now. Healthcare policy largely mandated by the US government requires them to make this determination. Today the Lord led me in “buying” him 3 more days after negotiating with the Physiatrist on Michael’s unit. Go Sister Bear, occupational therapist.

Overall it looks like Mike will be discharged soon to a nursing home for placement and not further rehabilitation. This would be sad. His beloved fiancé, Lisa, is doing the best she can to juggle her own responsibilities, visit Mike at the hospital an hour away from their home, and complete paperwork/phone calls/research/etc. needed for his discharge planning. He would not likely receive therapy services thereafter until his Medicaid kicks in; when it does start the amount for which he is eligible could be limited. I just hope they get him the proper wheelchair, feeding instructions, and do more than keep him “clean and dry” in a long term care facility. I don’t have high hopes for this at the moment.

In time perhaps Michael will be able to receive skilled therapy services and return home. In time perhaps Michael’s eligibility for VeteransAdministration and community services will be determined. To return home he will need to be safe enough to be left home alone when Lisa is at work while she graciously continues to provide for both of their needs in addition to her 13 year old son. We are all praying for them at this incredibly stressful time in their lives. My burden from afar (3 hours by car) is light by comparison. Sure I am making a few phone calls, found a family member with a commode, and am working on locating a walker but that is small compared to his incredible care needs. I do pray that some additional resources appear soon . . .

Sister Julie

This past weekend was a tale of two extremes got me. I started drinking Bulletproof coffee this past Friday: Freshly ground-and-brewed, mycotoxin-free, Swiss water decaffeinated coffee with ghee (butter) and MCT (derivative of coconut) oil. Everything gets blended in our Vitamix for a frothy hot drink that is quite good. (Remember, I am used to consuming unusual foods these days!) I had also begun taking a special formulation of B vitamins from Dr. Amy Yasko’s website to support some nutrigenomic issues. (Since the Functional Medicine MD set me adrift last week I struck out on my own for new solutions.) Saturday was an incredible day: waking up without seizures and enough energy to get showered and dressed before 10:00 a.m. just doesn’t happen for me! By 10:30 a.m. I had joined my hubby in cleaning our garage! Four hours later we were at a logical stopping point with the project nearly completed. We will recycle, discard, or sell either online or at a garage sale a goodly amount of items we no longer need. Ahhhh. Feels good.

Then comes the other extreme: almost 2 days with intermittent seizure attacks and bedrest. Crap. I guess I should have worn a mask when cleaning the garage? Maybe I shouldn’t have increased the MCT oil to twice per day? Or maybe the greatly increased activity level was just too much for this tender frame? Crap again. This is such a high price to pay for just taking care of our home. I enjoyed my time working with Steve so very much. I love doing projects with him! It had been soooooo long since our last big deal together . . . except for maybe driving up to Michigan to see Mike 2 weeks ago. Yeah that one took its toll on me as well. Crap, crap, crap.

So the worst case scenario for my brother is another stroke or even death. Since he appears to be stabilizing and improving I can set those fearful thoughts aside. I am quite confused about the Lord’s plan for all of this yet I choose to trust Him anyways. And as for my own illness, well, I guess the moments of improvement give me hope for my own recovery someday too.

On Sunday I decided to donn my firearm when Steve was selling some items from our home. He had opted to have the buyers meet us at the house. We took some precautions and everything worked out fine. His son, Daniel made out like a bandit (!) and we are pleased to have made it happen for him. But as that 380 pistol passed from my hand to its hidden resting place later that afternoon, I had to pause for a moment. At another time in my life it would have been dangerous for me to have a firearm in my possession. I had not yet learned how to shoot a gun, been taught gun safety, secured a carry permit, or decided for sure that life is worth living no matter what the current crisis.

You see I have faced overwhelming stressors in my life many, many times before. One time I had to ask a boyfriend to stay with me because the emotional pain that I was enduring was so great that I did not trust myself with my own life. I feared what I might do if I were to be left home alone. Flash forward about 15 years and that trust was tested once again. Gratefully eight years later, the overwhelming trauma of painful, daily seizure attacks, my brother’s stroke, and so much more is met with a solid faith in the Lord Jesus Christ and His plan for our lives. He is faithful. I trust in His power, His sovereignty over my fear, my pain, my doubt. Overcoming the traumas of the past by the grace of God taught me that. My firearm is for protection and nothing else.

When in doubt, I often start with the end in mind. I have always been a future-oriented person which I consider to be both a quality of leadership and a source of considerable anxiety! Perhaps my writings could talk a little less about my vulnerability and a little more about the Hero leading my heart PERIOD. With the God of the universe at the helm of my life I have nothing to fear, nothing to doubt. I will be able to endure the stress and the stress will be less with my hands off the “trigger” that represents a need for action at the wrong time. To wait, to rest and languish in His loving care helps me transcend the suffering. He has held me close in the comfort of His wings in the past and holds me close in the present as well. Many folks yearn to feel His presence. Hey, I get to feel it every day! He makes Himself real to me every single day.

Lastly, the greatest manifestation of darkness in this life is death. One day all too soon His glory will replace the darkness with His consuming light. All things will be made new and we who believe will reign with Him forever! My brother and I will be made whole to love and serve our great God. Wow! So I pray: Lord, help me to live this truth in today with hope and shining Your light for all to see. Thank You for being here with us in our journeys. If the load may be lighter, please bless us with Your healing grace and mercy. Until then, You are our King and praise be Your name, Emmanuel. Love you, Just Julie

While my brother’s fiancé is there at the hospital with him in the thick of things, his next of kin is a bit upset. I am too upset to make any rational decisions. The feelings run deep with me. It’s all I could do to be polite on the phone today to the social worker from the rehabilitation unit where Mike is hospitalized. At least Steve and I have the weekend to sort things out . . .

Very likely Mike will get booted out of the hospital next week and sent to be housed in a nursing home without additional rehabilitation services. His insurance is “Medicaid Pending” and his requiring of 24-hour physical care post discharge, a situation that cannot be met at home for valid reasons, is pushing the hospital to discharge him from their care. I don’t get it. In my 30+ year career in rehabilitation as an occupational therapist, the discharge criteria virtually always hinged on a lack of progress, not the particulars of discharge planning. It’s a new day: a new reality. If you can’t do what the government-driven healthcare system wants you to do then I guess they can wash their hands of you.

Perhaps he will go to a nursing home or perhaps by some miracle the Veterans Administration (VA) will accept him on such short notice. If the decision is the former, he will be fed 3 meals per day, kept clean and dry, and left to sit slumped in an overstretched wheelchair or geri chair in front of an out-of-tune entertainer from the long term care circuit with a pair of maracas shoved into his functional hand. The wailing of the demented residents will woo him to sleep at night as he tosses on his waterproof mattress to get comfortable around the bedsores that no one will find until it is too late for healing. Thickened Pepsi to drink? Not a chance. At least until his fiancé cleans up her make-up from crying long enough to ignore the swale of urine stench long enough to bring it to him. God bless her faithfulness visiting every day through this incredibly stressful ordeal!

Or perhaps it won’t be that bad. Maybe he will get into a VA rehabilitation facility with little red tape and get stronger. Regardless, the hope of at least a few weeks of physical, occupational, and speech therapy has vanished for the time-being. And Michael has no idea yet, what is about to happen to him next week. I left a message for his saint of a fiancé and she has not gotten back to me yet. Maybe she is in as big of SHOCK as I am. Maybe she is exhausted and horrified from touring nursing homes closer to where they lived in the “thumb” area of Michigan. I don’t blame her for taking a little time for herself to sort things out. My heart goes out to Lisa. She has been through so much these past two weeks as her life has changed forever.

As for me, 200 miles to the south and struggling with four hours of seizure attacks multiple times per day, I am overwhelmed with the stress of it all. Just seeing the missing flooring in our bathroom from yet another mold remediation project is enough to stub my toe even when the light is on. Somehow I completed a few errands outside the home this afternoon and made a simple dinner. I talked to a few family members who offered mixed consolation while I was stepping on the elliptical for 20 minutes, phone in hand. Geez! I haven’t used that thing in a few weeks! I must be stressed out. Thank goodness the nightly seizure attack episodes haven’t fully ramped up yet tonight: I needed to talk to you, Gentle Reader! I started to type and there you were. Thanks so much for being here. I can barely speak I am so very upset.

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Life goes on despite the drama of the moment. If Steve and I don’t impulsively drive 3 hours north to go to the hospital tomorrow and I’m stable enough, we will attend the 50th wedding anniversary open house of some friends. It will be good to enjoy some Christian fellowship. Then maybe my beloved Steve will start to work on the bathroom floor tile project and I’ll put together the jewelry orders that have been sitting at my work table this past week. Lord willing I’ll continue with the Spring clean-up of our gardens and Steve will mow the grass for the first time this year. Looks like the narcissus will be blooming within a day or two with their yellow-throated happy faces reaching up to soak up the sun. The sunshine will feel good on my broken frame as well and I will enjoy the freshness of the air this time of year. There’s no better hue of green than that of the tender leaves emerging from their Winter slumber: truly lime, truly sublime too. Some call it “horticulture therapy.” Gee, maybe I should go right now poke my finger in the dirt of the violets waiting to fill the self-watering planters I thought I might plant tomorrow . . . I need a fix of something and a shot of tequila is out of the question these days . . .

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Please pray for us. This sister bear is hurting more for her brother than anything right now. My beloved Steve has been so loving despite the challenges of my illness, demands of his work, and his other responsibilities. Lisa has got to be struggling as well, balancing work, the care of her teenage son (Alex), and assuming increasing responsibility for Michael’s affairs. She and Michael have known each other almost 7 years. Her 13 year old son has a great relationship with Michael too. Oh Lord, hold us all closely this night. Help us. Show us Your love, mercy, and grace. Guide us with wisdom. If it is Your will, heal my brother from the effects of this devastating stroke. Comfort him as he realizes all that has happened to him and show him hope, be real for him on his bed of sickness. He has reached out to you in his time of need. I am grateful for this and grateful that you are here with us. And thank you for the encouragement we find in Your Word:

¹⁶Therefore we do not lose heart. Though outwardly we are wasting away, yet inwardly we are being renewed day by day. ¹⁷For our light and momentary troubles are achieving for us an eternal glory that far outweighs them all. ¹⁸So we fix our eyes not on what is seen, but on what is unseen, since what is seen is temporary, but what is unseen is eternal. (2 Corinthians 4)

In Jesus’ name I pray. Amen.