Monday, October 27, 2008

Absence

I've been absent from blogging because I've been dealing with issues with my father. Dad moved up here at the end of August "for awhile." At the time he was in the middle of a divorce. He lasted barely a month in an apartment which was carved out of a garage. He called one week asking me if he washes his hair with mousse or if he applies it afterward. He called the next week asking to move in. Husband and I went to get him. The landlady suggested that I drive on our way out of the driveway.

Dad's driving has become an issue over the last several years. With three reportable accidents in one year and numerous fender benders, his almost ex-wife and my half-sister began to express their concerns. But he kept on driving. One day he arrived home with a brand new car and a two year lease.

Dad has always hated or distrusted doctors. He is also fairly stubborn about the things that he will and will not do. Dad went to doctors at various times over the past decade. Dad threw out any medicine they gave him to take.

Up here, Dad refused to go to a doctor for almost a month. He agreed first to go to my special eye doctor because his glasses haven't been right for several years (and various eye doctors where he used to live). My eye doctor agreed to report him to motor vehicles in Dad's home state as an impaired driver based upon Dad's "confusion." The glasses turned out well. With the addition of prisms, Dad is now able to read again. He can read out of books and newspapers and menus and can now in fact see the road signs.

Then I got Dad to go to our primary care doctor. I told him that if he were to have an appendix [attack] or a broken leg while visiting, it would be better for him to be established with a doc up here. I took Dad to our primary care doc who was absolutely wonderful with him. Doc got Dad to admit that one of the many medicines he had thrown out was a blood-thinner. Doc gave Dad a short e.k.g. which showed atrial fibrillation. (The treatment of choice for a-fib is a specific brand-name blood-thinner which can prevent many strokes). By the second visit, Doc had convinced Dad to take a prescription inhaler for his c.o.p.d., a low dose of an anti-depressant for the unspecified anxiety state that Dad won't admit to having, and the blood-thinner for the a-fib. Doc also got Dad to agree to a full blood panel and to go to the heart doc. (Doc also diagnosed dementia and aphasia, both of which I had suspected. Without neurological studies, we do not know what kind of dementia yet).

The heart doc is a very sharp young woman who knows absolutely shit about dementia. Dad got a full e.k.g. and an echo heart done. Heart doc informed me (but not Dad) most emphatically that Dad should not be driving. She was unwilling to report him to motor vehicles in his state, saying only that it wasn't her job to do so and adding something about any of his accidents being a liability.

Research on the internet revealed to me that docs are reluctant to report impaired drivers in any state-- even in states where docs are mandated to report-- because they are afraid of being sued by the impaired driver and/or the families of the impaired driver. A couple of visits later to our primary care doc and Dad agreed to go for a driving evaluation.

Dad and I went to his driving evaluation this morning at Sunnyview Hospital where I had gone for cognitive testing after my brain injury. (Schenectady New York if anyone has a burning desire to know where Sunnyview is). He did some sit down testing first which I got to see. He passed vision acuity with corrected distance vision of 20/40 but failed totally a bunch of other tests. He remembered two out of three simple words, failed serial sevens, failed connect-the-dots, failed drawing a clock showing a specific time of day. His reaction time was good for his age. The problem was just about everything else that shows how well his eyeballs are (not) working with his brain. Specifically, Dad failed things labeled as attention, distractibility, impulsivity, visual scanning, visual discrimination, color discrimination (to the point where the evaluator asked if he was color-blind, something I have been suspecting), and peripheral vision.

Dad left with the evaluator for a 45 minute test behind the wheel. When they came back, he said to me, "I failed." Then he added that he was only joking. But in fact he had.

Once back in the room, the evaluator asked Dad how he thought he did. He gave himself two or three demerits for several things. Then the evaluator gave her account of things. She had stopped him from turning in front of another car (that was the worst). He had gotten distracted by an unmarked police car, stopped too far away from lights and stop signs, driven fifteen miles under the speed limit and a variety of other things. She told him point-blank that she is recommending that he quit driving and that the time to stop driving is NOW. He decided that "people just want everyone over the age of 65 not to drive." Drat this denial shit.

Once back home, I fired off an e-mail to the half-sister so she and her mom would know how it went (http://www.sapphoqnfriends.blogspot.com). Dad's almost ex-wife (the divorce had been canceled) called then. The upshot of the whole thing is that the lease company would only offer a chance to buy out of the lease (almost ex-wife says she is not doing that) and that Dad has agreed to go back home to the almost ex-wife on Thursday. He will be driving himself and some of his stuff as he would not agree to any other arrangement. She will attempt to curtail his driving.



It is what it is. I cannot control any of this. As it stands now, that is what is happening. So we are back to where we were in July. Except maybe now Dad will take the blood-thinner for his a-fib, the antidepressant, and the inhaler for his c.o.p.d. And maybe his almost ex-wife will be able to get him to go to a primary care doc, a cardiac doc, and a neurologist who knows dementia and is willing to get involved with patients who have dementia. Maybe she will even be able to get him to agree to allow her to go in with to the doctor appointments. I hope that she will be able to curtail his driving somehow. That in itself requires divine intervention from divine beings which I don't believe in.

Everyone has financial problems now with the economy being all frucked up worldwide. We are no exception to that. And I am on disability. I cannot afford to buy his way out of his car lease. Dad's almost ex-wife is also having severe financial problems which dictate that she cannot do this either. I can't really blame the lease car company. Business is business. Folks who get leased cars are offered the opportunity to get stop-gap insurance in case they have to break a lease. Dad said no to that.

Dad's almost ex-wife doesn't want me to report Dad to the motor vehicles as being an impaired driver. She is against that. I have my own principles. Too late for that advice. The report was sent quite awhile ago. The eye doc also reported him. Dad's home state hasn't acted on the information yet. Dad's dad died in an accident when I was in second grade. I don't remember my paternal grandfather at all. I do remember the adults talking about it when he died. What I remember is that it was a head-on. Dad's dad was on a bridge, the long one in Miami. I may not remember what I heard accurately. Dad says his dad had gotten sideswiped or runned into. Dad says his dad had been a heavy drinker but had quit in Florida by switching to pitchers of orange juice. So "drunk" was not in the equation. Dad told me this morning that his dad should have quit driving. But that he himself does not have a driving problem. I hope Dad doesn't kill himself, get himself killed, or seriously maim or kill another human being while behind the wheel of a car. I have my own principles. I am responsible for what I know. Dad's home state will be getting another report, this time with copies of the driving evaluation included. It is hard to deal with the thought of Dad being angry with me, harder still for me to deal with the thought of Dad killing another human being behind the wheel if I do nothing.

I tried my best to get Dad to quit driving. I could not do it. No one else could either. Now I have a bill to pay (I decided that I would pay the bill rather than have Dad use that as an excuse not to go for the eval) and I am losing my Dad's company. I really love having Dad around. It has been a pleasure to have his company really. I learned quite a bit about politics and some of his memories of his life. To my credit, I got Dad to go to the eye doc and he is now able to read again after four years of messed-up glasses. I also got him to take medicine. I provided a safe place for him to live when he found that he could not live alone and did not want to live with his almost ex-wife. I would not have missed having Dad here for the last two months for the world. Dad's almost ex-wife wants him back. He wants to go back to take care of her, he told me. She misses him and she cries. They love each other still. I believe in love. I hope it will be enough this time.

I myself have learned some things while Dad has been here. Dad helped me establish a cleaning routine-- something which I have been unable to do on my own. I learned to eat slower and to eat grapes instead of junk food. (Yes, I am having a total life change and in the process am beginning to slowly lose weight!). I learned that doctors do not always do the right thing because they are afraid of being sued. I learned that I am responsible for what I know, even if acting on my knowledge is difficult. I learned again that it is not weakness to ask for help. I hope that I will be able to graciously quit driving when the time comes for me to do so or perhaps even before the time comes. Public safety trumps anyone's personal "right" to keep driving when they are a loaded weapon behind the wheel with no safety stop.




Dad was the one who taught me how to drive when the driver's ed instructor at my high school could not. Damn it all. The driver's ed instructor spoke in a flat monotone voice, probably through no fault of her own. She could not teach me. She reacted to my driving inability with obvious nervousness. One time that I remember specifically is on a snowy morning, I had turned into the sewer at the end of a block instead of turning right onto the next block. The car got stuck in the snow. She had me rock it back and forth and then proceed to turn. She insisted I go around the same block three times. Each time the same result occurred. I got the car stuck in the sewer grating. A more rational driver's ed instructor might have handled things differently perhaps-- hey we can try a right hand turn on a different block-- but not this one. Looking back at it now, I don't think it was all due to my right hand turns. I think it was the weather.

At any rate, I told Dad what was not happening in my driver's ed behind-the-wheel instruction time. And I had failed the first driving test for my license. Dad then borrowed a different length car every Sunday and had me drive in a variety of conditions. We drove all over. I even drove in New York City amidst a bunch of irate cabbies. Dad came with me for my second attempt and I got my license that time.

Emotionally I still assign blame to the driver's ed instructor for being unable to effectively teach me. Intellectually I now know that my learning style was vastly dissimilar to what that poor woman was used to dealing with.



In many ways my dad and I are alike. We both have sensitivities to a variety of tastes, sounds, and textures. For example, Dad finds the texture of yogurt to be disgusting. While I will eat yogurt, I refuse to wear the polyester fleeces which he relishes. Dad hates the loud tick-tick sound of his car blinker. That doesn't bother me. What I can't stand is the sound emitted by those white noise machines that some people get to block unpleasant sounds. And neither one of us care for fluorescent lights. We can both "hear" them.

I have a traumatic brain injury from my car accident. Dad has some kind of dementia because his brain is puking on him. I have wondered several times over the past couple of months if his dementia is actually an undiagnosed brain injury from one of his many accidents. He will not admit to hitting his head, having a concussion or whiplash. Neither will his almost ex-wife. To me, having brain damage from a car accident is preferable to having a dementia. When I've suggested that Dad may have a t.b.i. either instead of or in addition to dementia, Dad's almost ex-wife reacts with horror. Dad's almost ex-wife doesn't really think he has a dementia. Dad still knows his social security number. And he can dress himself and have rational conversations about politics. Dementia involves more than rote memory. Rote memory is not terribly complex by nature. Dad can remember his earlier life. He cannot remember what day it is today. He has difficulty forming new memories. That is dementia.

I could get lyrical here and write shit like, "Dementia is not losing oneself, it is an enfolding and a transformation." Those words make me want to puke. They aren't true. They hide pain. Pain is painful. Much better to face the pain than to hide behind words I think. My heart is broken a thousand thousand times. Those words are true.

spike